Provider Demographics
NPI:1235256272
Name:HOWE, VAUGHN THEODORE (PA)
Entity Type:Individual
Prefix:MR
First Name:VAUGHN
Middle Name:THEODORE
Last Name:HOWE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:20280 N 59TH AVE
Mailing Address - Street 2:STE 115-617
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6850
Mailing Address - Country:US
Mailing Address - Phone:602-795-8700
Mailing Address - Fax:602-795-8701
Practice Address - Street 1:2601 CHERRY AVE STE 200
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4208
Practice Address - Country:US
Practice Address - Phone:360-415-9110
Practice Address - Fax:360-733-8320
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2687363AM0700X
WAPA60905259363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2687OtherAZ LICENSE
WAPA60905259OtherWA LICENSE