Individual
MRS. TINA FAITH DERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1012 SOUTH THIRD STREET, COLUMBIA FAMILY CLINIC, DAYTON, WA 99328
(509) 382-3200
(509) 382-2748
Mailing address
1012 SOUTH THIRD STREET, DAYTON, WA 99328
(509) 382-2531
(509) 382-9359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2004-0030
NM
363A00000X
Physician Assistant
Primary
PA60426271
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83320253
—
NM
01
—
PA2004-0030
PA LICENSE
NM
Enumeration date
11/16/2005
Last updated
03/07/2023
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