Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jack Robert Kruse, SUDPT

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1457987992

Mr. Jack Robert Kruse, SUDPT is a Student in an Organized Health Care Education/Training Program in Shoreline, Washington. Licensed in Washington. Registered with an NPI since 2020.

Licensed in
WA
In the registry since
2020
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Shoreline, WA

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Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (WA)

Record details

NPI number1457987992
Entity typeIndividual (Type 1)
GenderMale
Credentials SUDPT
Sole proprietorNo
NPI enumeratedMarch 17, 2020
Last updated in NPPESMarch 17, 2020
Certification dateMarch 17, 2020

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