Provider Demographics
NPI:1811226962
Name:BICHLER, KEVIN R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:R
Last Name:BICHLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:BICHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:12418 E SALTESE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0357
Mailing Address - Country:US
Mailing Address - Phone:509-822-7719
Mailing Address - Fax:509-822-7986
Practice Address - Street 1:12418 E SALTESE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-822-7719
Practice Address - Fax:509-822-7986
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60125661363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2042496Medicaid