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Jared Waters
NPI 1023701927 · on the registry since 2023 · sole proprietor
Practice
- Address
- 5673 Airport Rd
Roanoke, VA 24012 - Phone
- (540) 523-8080
- Organisation at this address
- Iyh I Llc
Mark Bogert
Intercept Youth Services, Inc
Intercept Youth Services, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 20
Additional practice sites
- 5500 Staples Mill Rd, Henrico, VA
Registry record
- Primary taxonomy
- Physician Assistant
363A00000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-08-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia