Provider Demographics
NPI:1629544325
Name:KAUZLORIC, JAYNE E (MN, RN)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:E
Last Name:KAUZLORIC
Suffix:
Gender:F
Credentials:MN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2308
Mailing Address - Country:US
Mailing Address - Phone:206-477-8256
Mailing Address - Fax:206-296-0184
Practice Address - Street 1:2124 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121
Practice Address - Country:US
Practice Address - Phone:206-477-8256
Practice Address - Fax:206-296-0184
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00059068163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health