Provider Demographics
NPI:1467177469
Name:ROBISON, JANA MARIE
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:MARIE
Last Name:ROBISON
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 1:10333 19TH AVE SE STE 109
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4267
Mailing Address - Country:US
Mailing Address - Phone:425-742-4600
Mailing Address - Fax:
Practice Address - Street 1:3501 COLBY AVE STE 105
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4795
Practice Address - Country:US
Practice Address - Phone:425-422-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA159986363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health