Provider Demographics
NPI:1629465703
Name:HODGES, JASON (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HODGES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NICKERSON ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-1620
Mailing Address - Country:US
Mailing Address - Phone:206-486-1648
Mailing Address - Fax:206-832-3732
Practice Address - Street 1:101 NICKERSON ST STE 140
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1620
Practice Address - Country:US
Practice Address - Phone:206-486-1648
Practice Address - Fax:206-832-3732
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33105111N00000X
WA60636464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty