Provider Demographics
NPI:1629269592
Name:PASLEAN, JASON TODD (NP)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:TODD
Last Name:PASLEAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:7350 W DESCHUTES AVE STE B103
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7802
Practice Address - Country:US
Practice Address - Phone:509-783-0144
Practice Address - Fax:509-783-8244
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007784363L00000X, 363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8880PAOtherBSWA
WA0223770OtherLIWA
WA0223771OtherLIWA
WA9633502Medicaid
WA9633502Medicaid
WAG8867424Medicare PIN
WAG8884981Medicare UPIN