Healthcare Provider Details

I. General information

NPI: 1710274493
Provider Name (Legal Business Name): ASHLEIGH RENE PAVEY MD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEIGH RENE BORGES MD

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA WA
98431-5600
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, THIRD FLOOR
TACOMA WA
98431-5600
US

V. Phone/Fax

Practice location:
  • Phone: 532-968-2483
  • Fax:
Mailing address:
  • Phone: 253-968-0895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101252541
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101252541
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: