Moffitt, Jason Rusk

Moffitt, Jason Rusk is an individual health care provider with primary practice located at 520 S Cowley St , Spokane WA 99202-1315. He recently has 3 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / Dental Hygienist, Dental Providers / Dental Assistant. Dental Providers / Pediatric Dentistry is his primary health care specialty. Moffitt, Jason Rusk can be contacted via phone (509) 838-1445.

Contact Information

Primary practice address
520 S Cowley St Spokane WA 99202-1315
Phone: (509) 838-1445
Fax: (509) 455-8955
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 025103DE00007948 Washington
Dental Providers / Dental Hygienist 124Q00000X DH00001904 Washington
Dental Providers / Dental Assistant 126800000X

Profile Details

NPI number 1871683359
LBN Legal business name Moffitt, Jason Rusk
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871683359 NPPES
Washington MEDICAID 5036652

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