| Doctor Name: | JEFFREY JASON HERSHEY |
| NPI Number: | 1063818789 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA60514728 |
| Business Practice Address: | 518 E Clay Ave Chewelah, WA - 991098947 |
| Business Phone Number: | 5099358424 |
| Business Fax Number: | |
| Mailing Address: | 4133 Lyon And Moss Rd, LOON LAKE |
| State: | WA |
| Postal Code: | 991489769 |
| Phone Number: | 2086603496 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2014 |
| NPI Last Update Date: | 11/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA60514728 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |