Provider Demographics
| NPI: | 1780053793 |
|---|---|
| Name: | TURNER, ARIEL (PA-C) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ARIEL |
| Middle Name: | |
| Last Name: | TURNER |
| 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: | 2979 SQUALICUM PKWY STE 203 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BELLINGHAM |
| Mailing Address - State: | WA |
| Mailing Address - Zip Code: | 98225-1813 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 360-733-7670 |
| Mailing Address - Fax: | 360-647-1901 |
| Practice Address - Street 1: | 2979 SQUALICUM PKWY STE 203 |
| Practice Address - Street 2: | |
| Practice Address - City: | BELLINGHAM |
| Practice Address - State: | WA |
| Practice Address - Zip Code: | 98225-1813 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 360-733-7670 |
| Practice Address - Fax: | 360-647-1901 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2015-09-20 |
| Last Update Date: | 2022-08-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| WA | 60698227 | 363A00000X |
| WA | PA60698227 | 363AS0400X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| WA | 2075187 | Medicaid |