Provider Demographics
NPI:1487210878
Name:GRAVES, DEVON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DEVON
Middle Name:
Last Name:GRAVES
Suffix:
Gender:M
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 1:11604 W NEWKIRK RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-8909
Mailing Address - Country:US
Mailing Address - Phone:509-247-4494
Mailing Address - Fax:
Practice Address - Street 1:11604 W NEWKIRK RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-8909
Practice Address - Country:US
Practice Address - Phone:509-247-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical