Provider Demographics
NPI:1437219672
Name:VINCENT, PAUL ANDRE (PA-C)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ANDRE
Last Name:VINCENT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9912 75TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-3336
Mailing Address - Country:US
Mailing Address - Phone:253-984-6451
Mailing Address - Fax:253-984-6471
Practice Address - Street 1:DEPT OF FAMILY MEDICINE
Practice Address - Street 2:MADIGAN ARMY MED CTR
Practice Address - City:FT LEWIS
Practice Address - State:WA
Practice Address - Zip Code:98431
Practice Address - Country:US
Practice Address - Phone:253-966-7592
Practice Address - Fax:253-966-7653
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical