Tina Faith Derr in Dayton - Physician Assistant
Tina Faith Derr - NPI 1093797961
Tina Faith Derr is a Physician Assistant in Dayton, Washington. Tina Faith Derr practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Tina Faith Derr is 1093797961. The last update date is 2023-03-07.
Tina Faith Derr's current location address is 1012 South Third Street, Dayton, Washington. You can contact this provider via phone number 5093823200 and fax number 5093822748. The mailing address for Tina Faith Derr is 1012 South Third Street, Dayton, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tina Faith Derr |
|---|---|
| Address | 1012 South Third Street, Dayton, Washington |
| Phone Number | 5093823200 |
| Fax Number | 5093822748 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1093797961 |
|---|---|
| Provider Enumeration Date | 2005-11-16 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 1012 South Third Street |
|---|---|
| City | Dayton |
| State | Washington (WA) |
| Post Code | 99328 |
| Phone Number | 5093823200 |
| Fax Number | 5093822748 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA2004-0030 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PA2004-0030 | NM | PA LICENSE | |
| 83320253 | NM | -- |
Post Comment/ Review Below
What is the Tina Faith Derr's unique identification number?
The Tina Faith Derr has been assigned the NPI (National Provider Identifier) Number 1093797961 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Tina Faith Derr is physically located?
The Tina Faith Derr is situated at the following address: 1012 South Third Street, Dayton, WA 99328.
What is the Tina Faith Derr's specialty and taxonomy code?
The Tina Faith Derr's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did Tina Faith Derr receive its 1093797961 assignment from the Centers for Medicare & Medicaid Services?
The Tina Faith Derr was assigned its 1093797961 on 2005-11-16, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Tina Faith Derr most recently updated?
The details pertaining to the Tina Faith Derr, including its address, specialty, and other relevant information, were last refreshed on 2023-03-07.