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General NPI Number Information
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NPI Number | 1609039825
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Entity Type | Individual
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Provider Name | KYLE MARLIN HOFFMANN PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1221 HIGHLAND AVE
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City | CLARKSTON
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State | WA
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Zip | 99403-2829
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Country | US
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Telephone | 509-758-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 W CARIBOU CT
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City | PLEASANT VIEW
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State | UT
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Zip | 84414-2699
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Country | US
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Telephone | 801-388-8412
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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 | 4887336-1206
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License Number State | UT
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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 | PA61478061
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4419
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601011492
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2021-0078
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License Number State | NM
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