Provider Demographics
NPI:1427045780
Name:GARCIA, DREW A (PA)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:TONASKET
Mailing Address - State:WA
Mailing Address - Zip Code:98855-8803
Mailing Address - Country:US
Mailing Address - Phone:509-486-3144
Mailing Address - Fax:509-486-3176
Practice Address - Street 1:525 BRANSON LANDING BLVD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2052
Practice Address - Country:US
Practice Address - Phone:417-335-7128
Practice Address - Fax:417-348-8007
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018009747363A00000X
IDPA-849363A00000X
WAPA10004240363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1010075Medicaid