Provider Demographics
NPI:1205663762
Name:WEST, JASON (HAS, NBC-HIS)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:HAS, NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8610
Mailing Address - Country:US
Mailing Address - Phone:850-476-0000
Mailing Address - Fax:
Practice Address - Street 1:1250 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8610
Practice Address - Country:US
Practice Address - Phone:850-476-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4413237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist