Provider Demographics
NPI:1679036032
Name:MCKINLEY, JASON HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:HOWARD
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S MARKET BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3423
Mailing Address - Country:US
Mailing Address - Phone:360-767-6300
Mailing Address - Fax:360-767-6320
Practice Address - Street 1:931 S. MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532
Practice Address - Country:US
Practice Address - Phone:360-767-6300
Practice Address - Fax:360-767-6300
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program