Provider Demographics
NPI:1780060491
Name:AITKEN, JASON PHILLIP (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:PHILLIP
Last Name:AITKEN
Suffix:
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 LILLY RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5030
Mailing Address - Country:US
Mailing Address - Phone:360-413-8250
Mailing Address - Fax:
Practice Address - Street 1:209 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5030
Practice Address - Country:US
Practice Address - Phone:360-413-8250
Practice Address - Fax:360-413-8830
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX782574367500000X
WAAP61025134367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered