Provider Demographics
NPI:1780925842
Name:MORIN, JASON CONNAN (CHA)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:CONNAN
Last Name:MORIN
Suffix:
Gender:M
Credentials:CHA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX KXA
Mailing Address - Street 2:HEALTH CLINIC IN CARE OF JASON MORIN
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99950-0340
Mailing Address - Country:US
Mailing Address - Phone:907-542-2222
Mailing Address - Fax:907-542-2223
Practice Address - Street 1:PO BOX KXA
Practice Address - Street 2:HEALTH CLINIC IN CARE OF JASON MORIN
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99950-0340
Practice Address - Country:US
Practice Address - Phone:907-542-2222
Practice Address - Fax:907-542-2223
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker