Provider Demographics
NPI:1538503040
Name:BARBARA SIMONS PA-C
Entity Type:Organization
Organization Name:BARBARA SIMONS PA-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-331-6535
Mailing Address - Street 1:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-0543
Mailing Address - Country:US
Mailing Address - Phone:360-331-6535
Mailing Address - Fax:360-331-6545
Practice Address - Street 1:1660 LAYTON RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-9456
Practice Address - Country:US
Practice Address - Phone:360-331-6535
Practice Address - Fax:360-331-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005078261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8881339Medicare PIN