Jeb Bolerjack, RN is a
Registered Nurse based in Longview, Washington. Jeb Bolerjack is licensed to practice in Washington (license number RN60344179) and his current practice location is
784 14th Ave, Longview, Washington. He can be reached at his office (for appointments etc.) via phone at
(360) 703-6400.
NPI number for Jeb Bolerjack is 1467940486 and his current mailing address is 1057 12th Ave, Longview, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1467940486.
Healthcare Provider's Profile
Full Name | Jeb Bolerjack |
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Gender | Male |
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Speciality | Registered Nurse |
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Location | 784 14th Ave, Longview, Washington |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1467940486
- Provider Enumeration Date: 04/25/2018
- Last Update Date: 06/27/2019
Medical Identifiers
Medical identifiers for Jeb Bolerjack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467940486 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | CP00005027 (Washington) | Secondary |
163W00000X | Registered Nurse | RN60344179 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeb Bolerjack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jeb Bolerjack, RN 1057 12th Ave, Longview, WA 98632-2509 Ph: (360) 636-3892 | Jeb Bolerjack, RN 784 14th Ave, Longview, WA 98632-2315 Ph: (360) 703-6400 |
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