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General NPI Number Information
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NPI Number | 1235420753
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Entity Type | Individual
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Provider Name | JAMES LEVI SHEARER PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 9040 A JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-4603
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Country | US
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Telephone | 253-967-6702
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Fax |
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Provider Business Mailing Address
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Address Line | 2662 STRYKER AVE APT B
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City | JOINT BASE LEWIS MCCHORD
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State | WA
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Zip | 98433-1023
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Country | US
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Telephone | 253-968-1068
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA203640
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60629545
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License Number State | WA
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