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General NPI Number Information
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NPI Number | 1023326386
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Entity Type | Individual
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Provider Name | MATTHEW THOMAS JAMES PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 08/06/2016
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Provider Practice Location Address
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Address Line | 234511 HWY 101 WEST
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City | PORT ANGELES
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State | WA
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Zip | 98363-2412
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Country | US
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Telephone | 360-452-6252
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Fax | 360-452-6274
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Provider Business Mailing Address
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Address Line | 121 RESOLUTE LN
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City | PORT LUDLOW
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State | WA
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Zip | 98365-9617
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Country | US
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Telephone | 360-301-9423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 60188639
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License Number State | WA
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