Provider Demographics
NPI:1629527031
Name:CROWLEY, JASON RICHARD (RN)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:RICHARD
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1370
Mailing Address - Country:US
Mailing Address - Phone:509-385-6959
Mailing Address - Fax:509-458-0359
Practice Address - Street 1:121 S ARTHUR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2253
Practice Address - Country:US
Practice Address - Phone:509-456-0438
Practice Address - Fax:509-458-0359
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60255315163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice