Provider Demographics
NPI:1427044510
Name:VATH, CHRISTY A (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:A
Last Name:VATH
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:PO BOX 3489
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98114-3489
Mailing Address - Country:US
Mailing Address - Phone:206-386-9500
Mailing Address - Fax:206-386-9605
Practice Address - Street 1:515 MINOR AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2120
Practice Address - Country:US
Practice Address - Phone:206-386-9500
Practice Address - Fax:206-386-9605
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004421363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5366VAOtherREGENCE
WA8355521Medicaid
WAP00016063OtherPALMETTO RR MEDICARE
WA169921OtherLABOR & INDUSTRY
WA5891740001OtherDME
WA5891740001OtherDME
WAP00016063OtherPALMETTO RR MEDICARE