Provider Demographics
NPI:1205895893
Name:GUAY, JOSEPH E (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:GUAY
Suffix:
Gender:M
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:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-788-6800
Mailing Address - Fax:360-788-6801
Practice Address - Street 1:2979 SQUALICUM PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1811
Practice Address - Country:US
Practice Address - Phone:360-788-6800
Practice Address - Fax:360-788-6801
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10001717363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7519071OtherAETNA
WA35353OtherREGENCE
WA1205895893Medicaid
WA139003OtherL&I AND CRIME VICTIMS
R57500Medicare UPIN
WAGAB11337Medicare PIN