Unknown Individual – Physician Assistant, NPI 1073609442
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
P O BOX 1267
CHEHALIS, WA 98532
Phone: (360) 736-1965
Fax: (360) 740-4170
Type: Mailing
1299 BISHOP RD
CHEHALIS, WA 985328758
Phone: (360) 748-0211
Fax: (360) 748-8732
Type: Mailing
Cooks Hill Road, Centralia, Lewis County, Washington, 98544, United States
CENTRALIA, WA 98531
Phone: (360) 736-1965
Fax: (360) 740-4170
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $266.
Total Amount is formed as General ($266) + Research ($0) + Ownership ($0) = $266.
Last reported payment date: 2024-10-10 • Largest payer in this snapshot: Novo Nordisk Inc ($85).
Total Amount
$266
General + Research + Ownership
Payments
13
Total payment records
General Amount
$266
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $85 |
| ABBVIE INC. | $46 |
| GlaxoSmithKline, LLC. | $40 |
| Lilly USA, LLC | $30 |
| Corium, LLC | $28 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98532)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| - | WA | |
| - | AK | |
| Nurse Practitioner | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| - | WA | |
| - | WA |
Reviews
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