MEDICARE: ALEXANDRA NICOLE PASHLEY PHYSICIAN ASSISTANT

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
1	363A00000X	Physician Assistant	13025498-1206	UT

General Provider Information

NPI Number	:	1679030274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA NICOLE PASHLEY PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	10228 W 52ND PL APT 10-310
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-6609
Country	:	US
Telephone Number	:	801-833-2390
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 FEATHER RIVER BLVD STE 10
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-4548
Country	:	US
Telephone Number	:	530-538-5620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2019
Last Update Date	:	07/14/2023

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