John Russell Prentice in Vancouver - Physician Assistant
John Russell Prentice - NPI 1497736110
John Russell Prentice is a Physician Assistant in Vancouver, Washington. John Russell Prentice practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for John Russell Prentice is 1497736110. The last update date is 2007-07-08.
John Russell Prentice's current location address is 11808 Ne Fourth Plain Rd, Vancouver, Washington. You can contact this provider via phone number 3602536947 and fax number 3602569547. The mailing address for John Russell Prentice is 11808 Ne Fourth Plain Rd, Vancouver, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Russell Prentice |
|---|---|
| Address | 11808 Ne Fourth Plain Rd, Vancouver, Washington |
| Phone Number | 3602536947 |
| Fax Number | 3602569547 |
| Sole Proprietor | X |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1497736110 |
|---|---|
| Provider Enumeration Date | 2005-11-09 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 11808 Ne Fourth Plain Rd |
|---|---|
| City | Vancouver |
| State | Washington (WA) |
| Post Code | 986825524 |
| Phone Number | 3602536947 |
| Fax Number | 3602569547 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA10002522 |
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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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What is the John Russell Prentice's unique identification number?
The John Russell Prentice has been assigned the NPI (National Provider Identifier) Number 1497736110 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the John Russell Prentice's physical address?
The John Russell Prentice is physically located at 11808 Ne Fourth Plain Rd, in the city of Vancouver, WA, with the postal code 986825524.
What is the John Russell Prentice's area of specialization and corresponding taxonomy classification?
The John Russell Prentice's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the John Russell Prentice receive its 1497736110 assignment from the Centers for Medicare & Medicaid Services?
The John Russell Prentice was assigned its 1497736110 by the Centers for Medicare & Medicaid Services on 2005-11-09.
As of what date were the details related to John Russell Prentice most recently updated or revised?
The information pertaining to John Russell Prentice, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.