TAD W. WESTDALE


Address: 1718 E Kessler Blvd, Longview, WA 98632-1842
Phone: 3607475800

TAD W. WESTDALE (NPI# 1639407109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639407109
Entity Type Individual
Full Name TAD W. WESTDALE
Credential PA-C
Practice Address 1718 E Kessler Blvd
Longview
WA 98632-1842
Mailing Address Po Box 3002
Longview
WA 98632-0302
Practice Telephone 3607475800
Practice Fax Number 3605753846
Mailing Telephone 3607475800
Mailing Fax Number 3605753846
Enumeration Date 2009-11-22
Last Update Date 2012-07-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA60115702 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WA LABOR & INDUSTRIES / CRIME VICTIMS 0255166 01
OR 500618673 05
WA 8561748 05
WA RAILROAD MEDICARE P00844161 01

Office Location

Street Address 1718 E KESSLER BLVD
City LONGVIEW
State WA
Zip Code 98632-1842

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245237262 Timothy A Randall Family Medicine 1718 E Kessler Blvd, Longview, WA 98632-1842 2005-07-05
1316434210 Caroline Nelson Emergency Medical Technician, Basic 1718 E Kessler Blvd, Longview, WA 98632 2018-04-16
1427407253 Joshua M Hamoud Internal Medicine 1718 E Kessler Blvd, Longview, WA 98632-1842 2016-06-13
1487001780 Robert Drummond Shepherd Internal Medicine 1718 E Kessler Blvd, Longview, WA 98632-1842 2016-05-17
1215303771 Adam Ryan Weeks Nurse Practitioner 1718 E Kessler Blvd, Longview, WA 98632-1842 2015-08-19
1891178653 Nicole Leanne Landry Family Medicine 1718 E Kessler Blvd, Longview, WA 98632-1842 2015-06-29
1972985505 Jocelyn Danielle Glessing Registered Nurse 1718 E Kessler Blvd, Longview, WA 98632-1842 2015-06-19
1295130516 Jonathan Christian Jennings Physician Assistant 1718 E Kessler Blvd, Longview, WA 98632-1842 2014-10-29
1457761280 Christopher Schwartz Family Medicine 1718 E Kessler Blvd, Longview, WA 98632-1842 2014-05-01
1134464365 Melissa Rae Bettes Nurse Practitioner 1718 E Kessler Blvd, Longview, WA 98632-1842 2012-11-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851992366 Honor Senior Care LLC Home Health Aide 1135 3rd Ave, Ste S101, Longview, WA 98632 2020-11-03
1417416728 Sam Wise Dentist 1538 11th Ave Lowr Columbia, Longview, WA 98632 2019-03-16
1053870717 Matthew Johnson Physician Assistant 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 2019-03-12
1295205367 Abid Valji Occupational Therapist Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 2018-11-30
1184106437 Peacehealth Durable Medical Equipment & Medical Supplies Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 2018-09-04
1982186318 Linda Joan Mason Licensed Practical Nurse 1153 23rd Ave, Longview, WA 98632 2018-09-01
1891291910 Ellen Sumner Hornbeak Physical Therapist 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 2018-04-05
1700399961 Johnna Joyce Knapp Speech-Language Pathologist 2615 Lilac St, Longview, WA 98632 2017-11-09
1841711868 Deborah Annette Burzynski Registered Nurse 1057 12th Avenue, Longview, WA 98632 2017-06-29
1598291122 Cheyenne West Counselor 1616 10th Avenue, Longview, WA 98632 2017-05-02
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841791274 Sjs, Pllc Physician Assistant 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 2018-02-21
1386642734 Kristi Nealy Physician Assistant 701 N 6th St, Longview, TX 75601-6608 2005-07-11
1184156812 Eric Pascual Physician Assistant 921 14th Avenue, Longview, WA 98632 2017-03-31
1801128715 Matthew John Pyrch Physician Assistant 1706 Washington Way, Longview, WA 98632-2952 2010-02-02
1538490297 Kimberly Anne Wyatt Physician Assistant 707 Hollybrook Dr, Longview, TX 75605-2410 2010-01-20
1639327307 Cynthie Michelle Kiefer Physician Assistant 1152 Douglas St, Longview, WA 98632-2452 2008-09-05
1609917160 Jason Scott Graeme Physician Assistant 1615 Delaware St, Longview, WA 98632-2367 2007-02-09
1972688497 Vada Ann Culpepper Physician Assistant 2131 S Mobberly Ave, Longview, TX 75602-3563 2006-10-25
1306958707 Brian Edward Mahon Physician Assistant 1230 7th Ave, Longview, WA 98632-3166 2006-08-31
1740392273 Catherine Anne Mahon Physician Assistant 1230 7th Ave, Longview, WA 98632-3166 2006-08-31
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Competitor

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City LONGVIEW
Zip Code 98632

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Dataset Information

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.

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