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NPI Code Detail

MEDICARE: NATHAN AARON DE WITT PA-C

MEDICARE:   NATHAN AARON DE WITT  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
1363A00000XPhysician AssistantPA60455073WA

General Provider Information

NPI Number : 1790786705
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN AARON DE WITT PA-C
Provider Business Mailing Address
First Line : 1007 39TH AVE SE
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-2192
Country : US
Telephone Number : 253-435-3100
Fax Number : 253-435-3138
Provider Business Practice Location Address
First Line : 1007 39TH AVE SE
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-2192
Country : US
Telephone Number : 253-435-3100
Fax Number : 253-435-3138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 04/17/2025

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Directions to “ NATHAN AARON DE WITT PA-C” Practice Location

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