MEDICARE: WILLIAM A BUCHANAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA10004682	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA10004682	OTHER	WA	STATE LICENSE

General Provider Information

NPI Number	:	1376750794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM A BUCHANAN PA-C

Provider Business Mailing Address
First Line	:	18323 BOTHELL EVERETT HWY
Second Line	:	SUITE 220
City	:	BOTHELL
State	:	WA
Zip	:	98012-5246
Country	:	US
Telephone Number	:	425-806-5750
Fax Number	:	425-806-5701

Provider Business Practice Location Address
First Line	:	18323 BOTHELL EVERETT HWY
Second Line	:	SUITE 220
City	:	BOTHELL
State	:	WA
Zip	:	98012-5246
Country	:	US
Telephone Number	:	425-806-5750
Fax Number	:	425-806-5701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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Directions to “ WILLIAM A BUCHANAN PA-C” Practice Location

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