Provider Demographics
NPI:1497855308
Name:BEERMAN, GARY (PA-C/ARNP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:BEERMAN
Suffix:
Gender:M
Credentials:PA-C/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 4TH AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-9028
Mailing Address - Country:US
Mailing Address - Phone:425-576-1700
Mailing Address - Fax:425-827-7725
Practice Address - Street 1:3100 CARILLON PT
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7306
Practice Address - Country:US
Practice Address - Phone:425-576-1700
Practice Address - Fax:425-827-7725
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000996363LF0000X
WAPA10003561363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9602673Medicaid
WA114811OtherLABOR AND INDUSTRIES
WA8861874Medicare PIN