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Organization

NATHANIEL VAN VALIN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATHANIEL ASHBY VAN VALIN PAC (PHYSICIAN ASSISTANT)
(509) 924-7010
Entity
Organization

Contact information

Practice address
15425 E MISSION AVE, SPOKANE VALLEY, WA 99037-9505
(509) 924-7010
(509) 924-7532
Mailing address
1925 N HARMONY LN, SPOKANE VALLEY, WA 99016-8418
(509) 570-6133

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004910
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA10004910
STATE LICENSE NUMBER
WA
Enumeration date
08/05/2006
Last updated
03/07/2023
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