Provider Demographics
NPI:1598842635
Name:LASKEY, JEAN C (RN, LMP)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:C
Last Name:LASKEY
Suffix:
Gender:F
Credentials:RN, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 PROTECTION RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-9680
Mailing Address - Country:US
Mailing Address - Phone:360-531-3178
Mailing Address - Fax:360-385-3798
Practice Address - Street 1:231 W PATISON ST
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-9751
Practice Address - Country:US
Practice Address - Phone:360-531-3178
Practice Address - Fax:360-385-3798
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00065485163W00000X
WAMA00012783225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist