Provider Demographics
NPI:1144301714
Name:TVETEN, JASON J (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:TVETEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2105
Mailing Address - Country:US
Mailing Address - Phone:509-663-4838
Mailing Address - Fax:509-663-0106
Practice Address - Street 1:250 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2105
Practice Address - Country:US
Practice Address - Phone:509-663-4838
Practice Address - Fax:509-663-0106
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000085051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice