ALAN K MIRLY (NPI# 1891780524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891780524 |
Entity Type | Individual |
Full Name | ALAN K MIRLY |
Credential | PA |
Practice Address |
2525 Ne 139th St Ste 220 Vancouver WA 98686-2719 |
Mailing Address |
Po Box 4825 Portland OR 97208-4825 |
Practice Telephone | 3608822778 |
Practice Fax Number | 3606041616 |
Mailing Telephone | 3608822778 |
Mailing Fax Number | 3606041771 |
Enumeration Date | 2005-09-19 |
Last Update Date | 2019-12-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | PA60997082 | WA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363A00000X | Physician Assistant | PA-558 | ID | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | 807225300 | 05 | |
WA | 2143194 | 05 | |
ID | BLUE CROSS | PAWV4 | 01 |
Street Address |
2525 NE 139TH ST STE 220 |
City | VANCOUVER |
State | WA |
Zip Code | 98686-2719 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740660638 | Christoph Michael Prummer | Otolaryngology | 2525 Ne 139th St Ste 220, Vancouver, WA 98686-2719 | 2015-06-04 |
1295996122 | Scott Thomas Matz | Surgery | 2525 Ne 139th St Ste 220, Vancouver, WA 98686-2719 | 2008-06-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154891117 | Dorota Bozena Barton | Speech-Language Pathologist | 2121 Ne 139th Street Mob A, Suite 200, Vancouver, WA 98686 | 2018-12-03 |
1881161818 | Michelle Wolfe | Dental Assistant | A101, 1484, 14313 Ne 20th Ave, Vancouver, WA 98686 | 2018-10-29 |
1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
1801382387 | Kristopher K Kostenko | Dentist | 14201 Ne 20th Ave Ste A101, Vancouver, WA 98686 | 2018-07-08 |
1689164071 | Tegan Mills | Occupational Therapist | 7101 Ne 109th Street, Apt 64, Vancouver, WA 98686 | 2018-05-11 |
1164924122 | Kate Kristin Lawrence | Speech-Language Pathologist | 2215 Ne 104th St, Vancouver, WA 98686 | 2018-03-06 |
1437609567 | Elina Baranets | Registered Nurse | 14204 Ne Salmon Creek Avenue, Vancouver, WA 98686 | 2016-10-13 |
1386039550 | Sean Vikram Bhatia | Internal Medicine | Kaiser Salmon Creek, 14406 Ne 20th Ave, Vancouver, WA 98686 | 2015-04-03 |
1376988642 | Lindsay Hussey-andersen | Orthopaedic Surgery | 2525 Ne 139th St Ste 140, Vancouver, WA 98686 | 2013-05-01 |
1710253109 | Legacy Salmon Creek Hospital | Speech-Language Pathologist | 2121 Ne 139th St., Mob A, Ste 200, Vancouver, WA 98686 | 2012-03-29 |
Find all providers in zip 98686 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760028013 | Nina Mulargia | Physician Assistant | 4912 Ne 54th Ave, Vancouver, WA 98661-2742 | 2019-11-21 |
1902387863 | Theodore Rohan Thomas IIi | Physician Assistant | 2370 E 3rd Loop # 203a, Vancouver, WA 98661-7725 | 2018-08-28 |
1902310345 | Elowyn Smith | Physician Assistant | 16219 Se 12th St Ste 206, Vancouver, WA 98683-8906 | 2017-11-21 |
1154702728 | Kacie Marie Hamreus | Physician Assistant | 3101 Se 192nd Avenue, Vancouver, WA 98683 | 2015-06-09 |
1275910929 | Brandon Bruce Mascott | Physician Assistant | 16811 Se Mcgillivray Blvd # 101, Vancouver, WA 98683-3404 | 2015-05-01 |
1043614167 | Robyn Elizabeth Nash | Physician Assistant | 812 Se 136th Ave, Unit #l126, Vancouver, WA 98683-6943 | 2014-10-17 |
1588935498 | Krista Letsch | Physician Assistant | 14201 Ne 20th Ave Ste 3101, Vancouver, WA 98686-6414 | 2012-01-24 |
1528335130 | Jaime Erin Hamilton | Physician Assistant | 900 Ne 139th St Ste 202, Vancouver, WA 98685-2513 | 2011-11-28 |
1669760120 | Todd J. Cichosz | Physician Assistant | 2510 Columbia House Blvd, Vancouver, WA 98661-7763 | 2011-07-19 |
1992092324 | Jaime Larynn Simpkins | Physician Assistant | 400 Ne Mary Joseph Place, Vancouver, WA 98664 | 2011-07-06 |
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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.