Individual
KAYLA IWAHASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 E MILBER ST, TUCSON, AZ 85714
(520) 294-0005
Mailing address
5441 E 8TH ST, TUCSON, AZ 85711-3108
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006441
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-1815
MEDICARE
AZ
05
—
912044
—
AZ
01
—
ZFQ31815
MEDICARE
AZ
Enumeration date
09/08/2016
Last updated
11/15/2019
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