Wortham, Jared Rex

Wortham, Jared Rex is an sole proprietor health care provider with primary practice located at 1550 S Pioneer Way , Moses Lake WA 98837-4613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wortham, Jared Rex can be contacted via phone (509) 793-9787.

Contact Information

Primary practice address
1550 S Pioneer Way Moses Lake WA 98837-4613
Phone: (509) 793-9787
Fax: (509) 764-3263
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X O-0924 Idaho
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OP61442055 Washington

Profile Details

NPI number 1902241235
LBN Legal business name Wortham, Jared Rex
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2013
Last updated Aug 10th, 2023 - about 3 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 1902241235 NPPES
Washington MEDICAID 2253195

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