GLENN ANDREW MAHONEY (NPI# 1841263365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841263365 |
Entity Type | Individual |
Full Name | GLENN ANDREW MAHONEY |
Credential | PAC |
Practice Address |
8910 Vernon Road Lake Stevens WA 98258 |
Mailing Address |
3901 Hoyt Avenue Everett WA 98201 |
Practice Telephone | 4253350966 |
Practice Fax Number | 4253355145 |
Mailing Telephone | 4253395462 |
Enumeration Date | 2006-02-08 |
Last Update Date | 2009-12-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60042438 | WA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC942 | NV | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | 100507753 | 05 | |
NV | 100507754 | 05 |
Street Address |
8910 VERNON ROAD |
City | LAKE STEVENS |
State | WA |
Zip Code | 98258 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376695551 | The Everett Clinic, Pllc | Durable Medical Equipment & Medical Supplies | 8910 Vernon Road, Lake Stevens, WA 98258 | 2007-01-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790349116 | Page A Thompson | Assistant Behavior Analyst | 9821 North Davies Rd, Lake Stevens, WA 98258 | 2019-05-01 |
1811490550 | Washington Dental Corporation PC | Dentist | 907 Frontier Circle E, Suite 110, Lake Stevens, WA 98258 | 2018-03-08 |
1881140499 | Tracy L. Delorm, D.d.s. Pllc | Dentist | 9514 4th St. Ne Unit 102, Lake Stevens, WA 98258 | 2016-09-01 |
1932587870 | Nathan Cory | Contractor | 25 95th Dr Ne #105, Lake Stevens, WA 98258 | 2015-05-12 |
1902249063 | Troy Slover | Family Medicine | 31 Ne Route 300 Suite 200, Belfair, WA 98258 | 2013-04-09 |
1154675064 | Pspd - Lake Stevens Pllc | Dentist | 9421 N. Davies Road #a, Lake Stevens, WA 98258 | 2012-10-30 |
1053670364 | Ashley Nicole Sherman | Massage Therapist | 9623 32nd St Se Bldg D Ste 115, Lake Stevens, WA 98258 | 2012-05-07 |
1326344391 | Lyman Charles Drown | Specialist/Technologist | 9514 4th Street Ne, Suite 101, Lake Stevens, WA 98258 | 2011-02-08 |
1942504071 | Rebekah Erin Callahan | Marriage & Family Therapist | 7304 10th St. Se #b201, Lake Stevens, WA 98258 | 2011-01-04 |
1376857235 | Ronald L Rhea | Massage Therapist | 7812 12th St Se, Lake Stevens, WA 98258 | 2010-08-03 |
Find all providers in zip 98258 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
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 |
City | LAKE STEVENS |
Zip Code | 98258 |
Please comment or provide details below to improve the information on GLENN ANDREW MAHONEY.
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.