Provider Demographics
NPI:1952355331
Name:SUMMERS, NATHAN W (PA-C)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:W
Last Name:SUMMERS
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:10330 MERIDIAN AVE N
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9451
Mailing Address - Country:US
Mailing Address - Phone:206-368-6360
Mailing Address - Fax:206-368-6361
Practice Address - Street 1:10330 MERIDIAN AVE N
Practice Address - Street 2:SUITE 270
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9451
Practice Address - Country:US
Practice Address - Phone:206-368-6360
Practice Address - Fax:206-368-6361
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2013-06-27
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Provider Licenses
StateLicense IDTaxonomies
FLPA9103708363A00000X
PAMA054316363A00000X
WAPA60289681363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant