JUSTIN MANDEVILLE (PA-C) – Physician Assistant, NPI 1073019550

JUSTIN MANDEVILLE (PA-C) is a healthcare provider. based in Jblm, Washington. specializing in Physician Assistant. They hold the professional credentials PA-C. The NPI Number for JUSTIN MANDEVILLE (PA-C) is 1073019550

Main info

Male
Name
JUSTIN MANDEVILLE (PA-C)
NPI
1073019550
Phone
Not provided
Address
BLDG 11582 C STREET
Enumeration Date
3 April 2018
Last Update Date
25 July 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:8State licenses:0Digital endpointsOther names

Provider Addresses for JUSTIN MANDEVILLE (PA-C)

  • BLDG 11582 C STREET

    OKUBO CLINIC

    JBLM, WA 98433

    Phone:

    Type: Mailing

  • 210 E NEEDMORE HWY

    GRAND LEDGE, MI 488379438

    Phone: (517) 667-8729

    Type: Location

  • LANDSTUHL REGIONAL MEDCEN

    ATTN: MCEU-LST-QM-CR UNIT 33100

    APO, AE 09180

    Phone:

    Type: Mailing

  • 9391 PRARRIE WIND ST

    YELM, WA 98597

    Phone: (517) 667-8729

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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.

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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 98433)

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Reviews

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Frequently asked questions

How do payers reference JUSTIN MANDEVILLE (PA-C)?
For JUSTIN MANDEVILLE (PA-C), use NPI 1073019550 as the unique 10-digit identifier.
Would JUSTIN MANDEVILLE (PA-C) appear as active to a payer?
You can treat JUSTIN MANDEVILLE (PA-C) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for JUSTIN MANDEVILLE (PA-C)?
At a glance, JUSTIN MANDEVILLE (PA-C) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JUSTIN MANDEVILLE (PA-C)?
Travel planning: use Jblm, Washington as the reference point for JUSTIN MANDEVILLE (PA-C), then confirm.
When was this NPI issued?
Enumeration for JUSTIN MANDEVILLE (PA-C) is noted as April 3, 2018 where the registry provides it.

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