Provider Demographics
NPI:1942438841
Name:WRIGHT, JASON DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DAVID
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5908 BEDFORD ST STE C
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6605
Mailing Address - Country:US
Mailing Address - Phone:509-792-1404
Mailing Address - Fax:509-792-1405
Practice Address - Street 1:5908 BEDFORD ST STE C
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-6605
Practice Address - Country:US
Practice Address - Phone:509-792-1404
Practice Address - Fax:509-792-1404
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60504027208600000X, 2086S0122X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOP60504027OtherPHYS LICENSE
UT8806175-1204OtherPHYSICIAN LICENSE