| NPI | 1528460813 |
|---|---|
| Professional Name | JAKE CREVISTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201405518NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200841169RN) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2024-09-20 |