Provider Demographics
NPI:1164464053
Name:SCHIRA, JOHN C (PA C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:SCHIRA
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 MARTIN WAY E
Mailing Address - Street 2:SUITE 117
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6502
Mailing Address - Country:US
Mailing Address - Phone:360-413-6910
Mailing Address - Fax:360-413-9026
Practice Address - Street 1:6700 MARTIN WAY E
Practice Address - Street 2:SUITE 117
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-6502
Practice Address - Country:US
Practice Address - Phone:360-413-6910
Practice Address - Fax:360-413-9026
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10001917363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WASC0968OtherBSWA
WA0137179OtherLIWA
WA8348971Medicaid
WA8348971Medicaid
WAS47552Medicare UPIN
WASC0968OtherBSWA