Provider Demographics
NPI:1275224990
Name:UMBERGER, JASON (DAC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:UMBERGER
Suffix:
Gender:M
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8646 S DESERT DOVE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5147
Mailing Address - Country:US
Mailing Address - Phone:520-226-1123
Mailing Address - Fax:
Practice Address - Street 1:8646 S DESERT DOVE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-5147
Practice Address - Country:US
Practice Address - Phone:520-226-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-010126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist