Individual
PATRICIA ANN LUPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 MARTIN L KING JR WAY, TACOMA, WA 98405-4234
(253) 459-7956
(253) 459-7861
Mailing address
315 MARTIN L KING JR WAY, TACOMA, WA 98405-4234
(253) 459-7956
(253) 459-7861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10974
MN
363A00000X
Physician Assistant
1578
MN
363A00000X
Physician Assistant
Primary
PA60638457
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P01241713
MEDICARE RAILROAD
MN
Enumeration date
06/21/2011
Last updated
08/08/2016
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