Provider Demographics
NPI:1801089123
Name:ADEYEMI, FELIX A (PHYSICIAN ASSISSTANT)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:A
Last Name:ADEYEMI
Suffix:
Gender:
Credentials:PHYSICIAN ASSISSTANT
Other - Prefix:
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Mailing Address - Street 1:500 SW 7TH ST STE A205
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2983
Mailing Address - Country:US
Mailing Address - Phone:877-522-1275
Mailing Address - Fax:509-491-3031
Practice Address - Street 1:516 N ROLLING RD STE 301
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4133
Practice Address - Country:US
Practice Address - Phone:877-522-1275
Practice Address - Fax:509-491-3031
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0003585OtherMBP
1077284OtherNCCPA
MDPA66622OtherCDS
1077284OtherNCCPA