Wortham, Jared Rex
Wortham, Jared Rex is an sole proprietor health care provider with primary practice located at 1550 S Pioneer Way , Moses Lake WA 98837-4613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wortham, Jared Rex can be contacted via phone (509) 793-9787.Contact Information
Primary practice address
1550 S Pioneer Way
Moses Lake WA 98837-4613
Phone: (509) 793-9787
Fax: (509) 764-3263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | O-0924 | Idaho |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | OP61442055 | Washington |
Profile Details
| NPI number | 1902241235 |
|---|---|
| LBN Legal business name | Wortham, Jared Rex |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 30th, 2013 |
| Last updated | Aug 10th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902241235 | NPPES |
| Washington | MEDICAID | 2253195 |
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