Provider Demographics
NPI:1578964193
Name:EASTMAN, CHELSEA M (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:105 W 8TH AVE STE 318C
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2318
Mailing Address - Country:US
Mailing Address - Phone:509-474-6650
Mailing Address - Fax:509-474-6646
Practice Address - Street 1:105 W 8TH AVE STE 318C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2318
Practice Address - Country:US
Practice Address - Phone:509-474-6650
Practice Address - Fax:509-474-6646
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005216363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant