Provider Demographics
NPI:1790210573
Name:BATANGAN, ERIC KEI (PA-C)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:KEI
Last Name:BATANGAN
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 1:3240 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8509
Mailing Address - Country:US
Mailing Address - Phone:808-722-0359
Mailing Address - Fax:
Practice Address - Street 1:3240 14TH AVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8509
Practice Address - Country:US
Practice Address - Phone:360-866-7990
Practice Address - Fax:360-866-4577
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA6092772363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant