MEDICARE: GRANT WINFIELD 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

General Provider Information

NPI Number	:	1497560445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT WINFIELD PA-C

Provider Business Mailing Address
First Line	:	18305 SE NEWPORT WAY APT H101
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-7832
Country	:	US
Telephone Number	:	440-897-5505
Fax Number	:

Provider Business Practice Location Address
First Line	:	18305 SE NEWPORT WAY APT H101
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-7832
Country	:	US
Telephone Number	:	440-897-5505
Fax Number	:

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

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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Directions to “ GRANT WINFIELD PA-C” Practice Location

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