Provider Demographics
NPI:1568717163
Name:WARREN, JARED ALEXANDER (DO, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:ALEXANDER
Last Name:WARREN
Suffix:
Gender:M
Credentials:DO, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 WARRENSVILLE CENTER RD APT 211
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3726
Mailing Address - Country:US
Mailing Address - Phone:425-301-7914
Mailing Address - Fax:
Practice Address - Street 1:3333 WARRENSVILLE CENTER RD APT 211
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-3726
Practice Address - Country:US
Practice Address - Phone:425-301-7914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0000207X00000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery