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NPI Code Detail

MEDICARE: MR. CRAIG ELSNER PA

MEDICARE: MR. CRAIG ELSNER PA
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
1363A00000XPhysician AssistantPA10003376WA
2363AM0700XMedical Physician AssistantPA10003376WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01256420OTHERWARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2315777OTHERWAL&I POST 7/21/13

General Provider Information

NPI Number : 1427025857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CRAIG ELSNER PA
Provider Business Mailing Address
First Line : 820 N CHELAN AVE
Second Line :
City : WENATCHEE
State : WA
Zip : 98801-2028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 HIGHLINE DR
Second Line :
City : EAST WENATCHEE
State : WA
Zip : 98802-5341
Country : US
Telephone Number : 509-884-0614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 06/15/2022

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