Provider Demographics
NPI:1225426505
Name:SEARS, MARIKA (PA)
Entity Type:Individual
Prefix:
First Name:MARIKA
Middle Name:
Last Name:SEARS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BROADWAY ST FL 3
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4008
Mailing Address - Country:US
Mailing Address - Phone:408-327-1670
Mailing Address - Fax:406-329-5697
Practice Address - Street 1:500 W BROADWAY ST FL 3
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:408-327-1670
Practice Address - Fax:406-329-5697
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60531804363A00000X
MT76393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant