Provider Demographics
NPI:1356315808
Name:LO-TOMBLIN, JIN MEI (PA-C)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:MEI
Last Name:LO-TOMBLIN
Suffix:
Gender:F
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 1:62 W 7TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2321
Mailing Address - Country:US
Mailing Address - Phone:509-456-0262
Mailing Address - Fax:509-462-5059
Practice Address - Street 1:62 W 7TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2321
Practice Address - Country:US
Practice Address - Phone:509-456-0262
Practice Address - Fax:509-462-5059
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA-609363AS0400X
WAPA10004954363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8878130OtherMEDICARE PTAN
WAG8871055OtherMEDICARE PTAN
ID16678571OtherMEDICARE PTAN
ID1667857Medicare PIN
WAG8878130OtherMEDICARE PTAN
WAG8871055OtherMEDICARE PTAN