Provider Demographics
NPI:1215367198
Name:PINGATORE, JAIME LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LEE
Last Name:PINGATORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6909 S HOLLY CIR
Mailing Address - Street 2:STE 150
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6238
Mailing Address - Country:US
Mailing Address - Phone:303-694-2323
Mailing Address - Fax:303-694-9191
Practice Address - Street 1:6909 S HOLLY CIR
Practice Address - Street 2:STE 150
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6238
Practice Address - Country:US
Practice Address - Phone:303-694-2323
Practice Address - Fax:303-694-9191
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0003718363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant