Provider Demographics
NPI:1073106647
Name:UEMURA, JANE ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ELIZABETH
Last Name:UEMURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 36TH RD N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-4818
Mailing Address - Country:US
Mailing Address - Phone:701-340-1027
Mailing Address - Fax:
Practice Address - Street 1:4040 FAIRFAX DR STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1613
Practice Address - Country:US
Practice Address - Phone:703-292-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program