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NPI 1790210573

NPI 1790210573 : ERIC KEI BATANGAN PA-C : OLYMPIA, WA

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General NPI Number Information
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    NPI Number           |    1790210573
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC KEI BATANGAN PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/28/2017
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    Last Update Date     |    01/22/2025
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Provider Practice Location Address
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    Address Line         |    3240 14TH AVE NW 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98502-8509
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    Country              |    US
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    Telephone            |    360-866-7990
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    Fax                  |    360-866-4577
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Provider Business Mailing Address
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    Address Line         |    3240 14TH AVE NW 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98502-8509
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    Country              |    US
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    Telephone            |    808-722-0359
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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       |    PA6092772
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    License Number State |    WA
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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       |    
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    License Number State |    
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