is a Physician Assistant in Auburn, Washington. practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for is 1013969195. The last update date is .
's current location address is 202 Cross St Se, Auburn, Washington. You can contact this provider via phone number 2538768111. The mailing address for is 202 Cross St Se, Auburn, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 202 Cross St Se, Auburn, Washington |
| Phone Number | 2538768111 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1013969195 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 202 Cross St Se |
|---|---|
| City | Auburn |
| State | Washington (WA) |
| Post Code | 980025406 |
| Phone Number | 2538768111 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
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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 |
|---|---|---|---|
| 45941 | WA | STATE L&I | |
| 7070261 | WA | -- |
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