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General NPI Number Information
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NPI Number | 1669663597
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Entity Type | Individual
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Provider Name | ALLEN NOBLE PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 605 S COOLIDGE ST
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City | MOSES LAKE
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State | WA
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Zip | 98837-1893
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Country | US
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Telephone | 509-765-0674
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Fax | 509-765-6591
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Provider Business Mailing Address
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Address Line | 605 S. COOLIDGE STREET
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City | MOSES LAKE
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State | WA
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Zip | 98837-1863
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Country | US
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Telephone | 509-765-0674
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Fax | 509-765-6591
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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 | PA10005255
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License Number State | WA
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