Provider Demographics
NPI:1932299880
Name:BUCHAN, JENNIFER BETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:BETH
Last Name:BUCHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3908 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-2188
Mailing Address - Country:US
Mailing Address - Phone:253-848-5951
Mailing Address - Fax:253-845-7073
Practice Address - Street 1:3420 NE SAND HILL RD
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528-9007
Practice Address - Country:US
Practice Address - Phone:360-277-2444
Practice Address - Fax:360-277-2441
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2010-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q42672Medicare UPIN