Doctor Name: | MATTHEW THOMAS JAMES |
NPI Number: | 1023326386 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 60188639 |
Business Practice Address: | 2690 Ne Kresky Ave Chehalis, WA - 985322412 |
Business Phone Number: | 3603309595 |
Business Fax Number: | 3603309540 |
Mailing Address: | 2690 Ne Kresky Ave, CHEHALIS |
State: | WA |
Postal Code: | 985322412 |
Phone Number: | 3603309595 |
Fax Number: | 3603309560 |
NPI Enumeration Date: | 09/21/2010 |
NPI Last Update Date: | 09/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 60188639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |