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Jason Deiss

Community Health Worker in Laramie, WY. Individual provider (NPI-1).

NPI number1164032793
StatusActive
Last updated in NPPESAug 7, 2020

Details

NPI
1164032793
Entity type
Individual (NPI-1)
Name
Jason Deiss
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 7, 2020
Certification date
Aug 7, 2020
Last updated
Aug 7, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

4989 N 3rd St
Laramie, WY 82072-9548

Phone 307-745-8997

Mailing address

4989 N 3rd St
Laramie, WY 82072-9548

Phone 307-745-8997

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