Healthcare Provider Details

I. General information

NPI: 1649708363
Provider Name (Legal Business Name): ADAM HASSELL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W WELLESLEY AVE STE D
SPOKANE WA
99205-5009
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 509-598-7870
  • Fax: 509-325-7808
Mailing address:
  • Phone: 253-459-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61228029
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: