Provider Demographics
NPI:1821198672
Name:THOMPSON, PAULA D (PA-C)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:D
Last Name:THOMPSON
Suffix:
Gender:F
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 1:801 S STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2654
Mailing Address - Country:US
Mailing Address - Phone:509-363-7788
Mailing Address - Fax:509-363-7064
Practice Address - Street 1:525 S COWLEY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1381
Practice Address - Country:US
Practice Address - Phone:509-363-7788
Practice Address - Fax:509-363-7064
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004529363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAQ07036Medicare UPIN