Basic Information
| Provider Information | |||||||||
| NPI: | 1023326386 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 RESOLUTE LN | ||||||||
| Address2: | |||||||||
| City: | PORT LUDLOW | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983659617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603019423 | ||||||||
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| Practice Location | |||||||||
| Address1: | 234511 HWY 101 WEST | ||||||||
| Address2: | |||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983632412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604526252 | ||||||||
| FaxNumber: | 3604526274 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2010 | ||||||||
| LastUpdateDate: | 08/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 60188639 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.