Provider Demographics
NPI:1992395230
Name:TAKEDA, JANE E (DNP, FNP-BC, BSN, RN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:TAKEDA
Suffix:
Gender:F
Credentials:DNP, FNP-BC, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 DELAWARE LN
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1408
Mailing Address - Country:US
Mailing Address - Phone:360-566-4402
Mailing Address - Fax:360-566-4406
Practice Address - Street 1:7410 DELAWARE LN
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1408
Practice Address - Country:US
Practice Address - Phone:360-566-4402
Practice Address - Fax:360-566-4406
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61420190163W00000X
OR202009638163WM0705X
WAAP61477773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical