Provider Demographics
NPI:1215174669
Name:JARNES, JESSE (CRNA)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:JARNES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-0804
Mailing Address - Country:US
Mailing Address - Phone:208-661-9880
Mailing Address - Fax:541-523-1709
Practice Address - Street 1:3225 POCAHONTAS RD
Practice Address - Street 2:ST. ELIZABETH HEALTH SERVICES
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814
Practice Address - Country:US
Practice Address - Phone:541-523-8813
Practice Address - Fax:541-523-1709
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200340013RN163W00000X
OR200860055CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse