Provider Demographics
NPI:1235420753
Name:SHEARER, JAMES LEVI (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEVI
Last Name:SHEARER
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 1:2662 STRYKER AVE APT B
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98433-1023
Mailing Address - Country:US
Mailing Address - Phone:253-968-1068
Mailing Address - Fax:
Practice Address - Street 1:9040 A JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4603
Practice Address - Country:US
Practice Address - Phone:253-967-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA203640363A00000X
WAPA60629545363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA60629545OtherEMERGENCY MEDICINE