MEDICARE: ASHLEY MICHELLE JAVECH 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	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1487118493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MICHELLE JAVECH PA-C

Provider Business Mailing Address
First Line	:	18444 N 25TH AVE STE 310
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1266
Country	:	US
Telephone Number	:	866-974-2673
Fax Number	:	866-939-2673

Provider Business Practice Location Address
First Line	:	18444 N 25TH AVE STE 310
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1266
Country	:	US
Telephone Number	:	866-974-2673
Fax Number	:	866-939-2673

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

Provider Enumeration Date	:	01/23/2019
Last Update Date	:	01/23/2019

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