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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60115702 | WA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | LABOR & INDUSTRIES / CRIME VICTIMS | 0255166 | 01 |
OR | 500618673 | 05 | |
WA | 8561748 | 05 | |
WA | RAILROAD MEDICARE | P00844161 | 01 |
Street Address |
1718 E KESSLER BLVD |
City | LONGVIEW |
State | WA |
Zip Code | 98632-1842 |
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 |
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 |
Find all providers in zip 98632 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
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 |
Find all providers in LONGVIEW |
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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.