Provider Demographics
NPI:1053709972
Name:ORLOWSKI, JEAN
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:ORLOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 N CHASE RD
Mailing Address - Street 2:
Mailing Address - City:NEWMAN LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99025-8657
Mailing Address - Country:US
Mailing Address - Phone:509-226-0529
Mailing Address - Fax:509-621-0322
Practice Address - Street 1:6212 N CHASE RD
Practice Address - Street 2:
Practice Address - City:NEWMAN LAKE
Practice Address - State:WA
Practice Address - Zip Code:99025-8657
Practice Address - Country:US
Practice Address - Phone:509-226-0529
Practice Address - Fax:509-621-0322
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA751940376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA876183Medicaid