Provider Demographics
NPI:1376088898
Name:SOMERS, CASEY ALAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:ALAN
Last Name:SOMERS
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4729 95TH AVE NE UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-4138
Mailing Address - Country:US
Mailing Address - Phone:425-319-0196
Mailing Address - Fax:
Practice Address - Street 1:4729 95TH AVE NE UNIT A
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-4138
Practice Address - Country:US
Practice Address - Phone:425-319-0196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2021-04-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant