Provider Demographics
NPI:1437200797
Name:BETSCH, JUNE E (PAC)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:E
Last Name:BETSCH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 N THUNDERBIRD CIR STE 303
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1219
Mailing Address - Country:US
Mailing Address - Phone:480-435-9132
Mailing Address - Fax:480-776-0025
Practice Address - Street 1:4280 N ORACLE RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-2101
Practice Address - Country:US
Practice Address - Phone:520-887-0095
Practice Address - Fax:520-887-0160
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10002473363A00000X
AZ6308363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ161049Medicaid
WAUS0818718OtherAETNA PCP PIN
WA8368128Medicaid
WABE2993OtherBLUE SHIELD #
WA0039581OtherLABOR AND INDUSTRIES #
WA0039581OtherLABOR AND INDUSTRIES #
S80915Medicare UPIN
WA8368128Medicaid