Individual
MRS. MOON V TINAJERO-SIMMALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2101 NE 139TH ST STE 460, VANCOUVER, WA 98686-2325
(360) 487-2727
Mailing address
PO BOX 2077, PORTLAND, OR 97208-2077
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
58655
CA
363A00000X
Physician Assistant
PA2358
NV
363A00000X
Physician Assistant
Primary
PA61511235
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295330694
—
NV
01
—
PA2358
STATE LICENSE
NV
Enumeration date
12/02/2020
Last updated
04/30/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us