Provider Demographics
NPI:1790210573
Name:BATANGAN, ERIC KEI (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:KEI
Last Name:BATANGAN
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 1:4515 FAIRWOOD BLVD NE APT 474
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-2154
Mailing Address - Country:US
Mailing Address - Phone:808-722-0359
Mailing Address - Fax:
Practice Address - Street 1:35002 PACIFIC HWY S STE A105
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003
Practice Address - Country:US
Practice Address - Phone:253-944-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant