Provider Demographics
NPI:1710219621
Name:MCPHERSON, JAMES HN (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HN
Last Name:MCPHERSON
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 1:1608 S J ST FL 4
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4930
Mailing Address - Country:US
Mailing Address - Phone:253-274-7504
Mailing Address - Fax:253-985-2853
Practice Address - Street 1:1608 S J ST FL 4
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4930
Practice Address - Country:US
Practice Address - Phone:253-274-7504
Practice Address - Fax:253-985-2853
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20478363A00000X, 363AM0700X, 363AS0400X
WAPA60182613363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA20478OtherLICENSE
WA2009404Medicaid
WAPA60182613OtherWASHINGTON STATE LICENSE