Vastine, Clarence Jason

Vastine, Clarence Jason is an individual health care provider with primary practice located at 13555 W Mcdowell Rd Ste 103 , Goodyear AZ 85395-2625. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Vastine, Clarence Jason can be contacted via phone (623) 932-1157.

Contact Information

Primary practice address
13555 W Mcdowell Rd Ste 103 Goodyear AZ 85395-2625
Phone: (623) 932-1157
Fax: (623) 935-1045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP3558 Arizona

Profile Details

NPI number 1902121379
LBN Legal business name Vastine, Clarence Jason
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2010
Last updated Apr 29th, 2019 - about 6 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 1902121379 NPPES
Arizona Other Z136913 MEDICARE
Arizona MEDICAID 510044 MEDICARE

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