Provider Demographics
NPI:1891014502
Name:ALCOCER, STEVEN BENJAMIN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BENJAMIN
Last Name:ALCOCER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1401 S LAVENTURE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-6033
Mailing Address - Country:US
Mailing Address - Phone:360-424-7041
Mailing Address - Fax:360-424-2418
Practice Address - Street 1:2720 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2734
Practice Address - Country:US
Practice Address - Phone:360-424-7041
Practice Address - Fax:360-424-2418
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA18157363A00000X
WAPA61308522363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2259802Medicaid
CA18157OtherSTATE LICENCE