Provider Demographics
NPI:1790973923
Name:ISAAC, AARON LOUIS (PA C)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:LOUIS
Last Name:ISAAC
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:34515 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6761
Practice Address - Country:US
Practice Address - Phone:253-944-8100
Practice Address - Fax:253-944-7922
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005219363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0228409OtherLIWA
WA5056ISOtherBSWA
WA8945483Medicaid
WA0225602OtherLIWA
WA0228409OtherLIWA
WA8945483Medicaid
WAG8868657Medicare PIN