Jansen, Edward L

Jansen, Edward L is an individual health care provider with primary practice located at 2555 Marvin Rd Ne Pmg Sw Wa Hawks Prairie Im, Lacey WA 98516-3138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jansen, Edward L can be contacted via phone (360) 923-4600.

Contact Information

Primary practice address
2555 Marvin Rd Ne Pmg Sw Wa Hawks Prairie Im Lacey WA 98516-3138
Phone: (360) 923-4600
Fax: (360) 923-4663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00025461 Washington

Profile Details

NPI number 1972537918
LBN Legal business name Jansen, Edward L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated May 25th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972537918 NPPES
Washington MEDICAID 8304495
Washington Other 5389380
Washington Other 0201569
Washington Other 4764JA

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