Provider Demographics
NPI:1447543459
Name:ADAM, AARON L (PA-C)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:L
Last Name:ADAM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 NE 87TH AVE
Mailing Address - Street 2:STE 370
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1913
Mailing Address - Country:US
Mailing Address - Phone:360-397-3352
Mailing Address - Fax:360-604-1771
Practice Address - Street 1:2525 NE 139TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2719
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1755
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2012-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA60196323363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant