MR. THOMAS RUSSELL PRIESKORN (NPI# 1366421174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366421174 |
| Entity Type | Individual |
| Full Name | MR. THOMAS RUSSELL PRIESKORN |
| Credential | PA-C |
| Practice Address |
901 Mountain View Dr Shelton WA 98584-4401 |
| Mailing Address |
Po Box 1668 Shelton WA 98584-5001 |
| Practice Telephone | 3604261611 |
| Mailing Telephone | 3604261611 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2015-03-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004942 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8466955 | 05 |
| Street Address |
901 MOUNTAIN VIEW DR |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215916 | Douglas Fletcher Lindahl | Internal Medicine | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2005-06-16 |
| 1639778202 | Public Hospital District No 1 of Mason County | Medicare Defined Swing Bed Unit | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2020-10-23 |
| 1184230716 | John Benjamin Takagi | Physical Therapist | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2020-09-18 |
| 1891301560 | Diana Jean Franckowiak | Physical Therapy Assistant | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2020-09-18 |
| 1831705508 | Jeff Frisse | Physical Therapist | 901 Mountain View Dr, Rehabilitation Services, Shelton, WA 98584 | 2020-09-18 |
| 1598303232 | Sara Barrow | Pharmacist | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2019-12-12 |
| 1871037499 | Ingrid Lai | Pharmacist | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2016-12-16 |
| 1598130445 | Steven Huang | Pharmacist | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2015-12-03 |
| 1669853966 | Natalie Reynolds | Emergency Medicine | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2015-06-11 |
| 1467845180 | Candy Matson | Dietitian, Registered | 901 Mountain View Dr, Shelton, WA 98584-4401 | 2015-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942530647 | Russell R. Amaru | Physician Assistant | 2321 W Dayton Airport Rd, Shelton, WA 98584-6319 | 2010-01-04 |
| 1073848495 | Jessica Leigh Bursell | Physician Assistant | 4 Corporate Dr, Suite # 484, Shelton, CT 06484-6211 | 2009-10-04 |
| 1558529255 | Kathryn Nixon Thompson | Physician Assistant | 4 Corporate Dr., Suite 386, Shelton, CT 06484 | 2008-05-29 |
| 1063634277 | Mark A. Flores | Physician Assistant | 237 Professional Way, Shelton, WA 98584-4404 | 2007-05-03 |
| 1821113119 | Charles Tiffany Barret | Physician Assistant | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-03-19 |
| 1922165513 | Lisa Carol Dell | Physician Assistant | 237 Professional Way, Shelton, WA 98584-4404 | 2007-01-02 |
| 1639166176 | Kathryn P Hackney | Physician Assistant | 237 Professional Way, Shelton, WA 98584-4404 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. THOMAS RUSSELL PRIESKORN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.