Provider Demographics
NPI:1801128715
Name:PYRCH, MATTHEW JOHN (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOHN
Last Name:PYRCH
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 1338
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-7785
Mailing Address - Country:US
Mailing Address - Phone:360-423-9580
Mailing Address - Fax:360-423-6230
Practice Address - Street 1:1706 WASHINGTON WAY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2952
Practice Address - Country:US
Practice Address - Phone:360-423-9580
Practice Address - Fax:360-423-6230
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA 60131088363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical