Provider Demographics
NPI:1164728705
Name:MARANAN, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MARANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-1923
Mailing Address - Country:US
Mailing Address - Phone:206-252-0000
Mailing Address - Fax:
Practice Address - Street 1:2445 3RD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-1923
Practice Address - Country:US
Practice Address - Phone:206-252-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-30
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60331800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist