person
Mr. Jack Robert Kruse, SUDPT
Student in an Organized Health Care Education/Training Program in Shoreline, Washington
NPI 1457987992

Jack Robert Kruse is a Student in an Organized Health Care Education/Training Program based in Kirkland, WA. Jack Robert Kruse practices in Shoreline, WA and has the professional credentials of SUDPT. The NPI Number for Jack Robert Kruse is 1457987992 and holds a License No. (Washington).

The current practice location address for Jack Robert Kruse is 16715 Aurora Ave N Ste 102, Shoreline, WA and can be reached out via phone at 206-546-9766 and via fax at 206-542-0326.

Location: 16715 Aurora Ave N Ste 102, Shoreline, WA, 98034-5250
person
Provider Profile Details
NPI Number
1457987992
Provider Name
Jack Robert Kruse
Credential
SUDPT
Provider Entity Type
Individual
Gender
Male
Address
16715 Aurora Ave N Ste 102, Shoreline, WA, 98034-5250
Phone Number
206-546-9766
Fax Number
206-542-0326
Provider Enumeration Date
03/17/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
16715 Aurora Ave N Ste 102
City
State
Zip
98133-5310
Phone Number
206-546-9766
Fax Number
206-542-0326
person
Provider Business Mailing Address Details
Address
16715 Aurora Ave N Ste 102
City
State
Zip
98133-5310
Phone Number
206-546-9766
Fax Number
206-542-0326
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
(Washington)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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