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NPI Code Detail

MEDICARE: DAVID FINE PA-C

MEDICARE: DAVID FINE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician AssistantOA60611779WA

General Provider Information

NPI Number : 1326440223
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID FINE PA-C
Provider Business Mailing Address
First Line : 3800 SUMMITVIEW AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98902-2715
Country : US
Telephone Number : 509-248-7849
Fax Number : 509-248-8291
Provider Business Practice Location Address
First Line : 4003 CREEKSIDE LOOP
Second Line :
City : YAKIMA
State : WA
Zip : 98908-3962
Country : US
Telephone Number : 509-248-3263
Fax Number : 509-225-2702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2014
Last Update Date : 04/08/2019

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