Provider Demographics
NPI:1417228024
Name:LAW, JASON RYAN (ARNP)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:RYAN
Last Name:LAW
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 SAND POINT WAY NE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3950
Mailing Address - Country:US
Mailing Address - Phone:206-535-8000
Mailing Address - Fax:
Practice Address - Street 1:4575 SAND POINT WAY NE
Practice Address - Street 2:SUITE 108
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3950
Practice Address - Country:US
Practice Address - Phone:206-535-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60254262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily