Fisk, Gregory D
Fisk, Gregory D is an individual health care provider with primary practice located at 529 Jasmine St , Omak WA 98841-9589. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fisk, Gregory D can be contacted via phone (509) 826-1600.Contact Information
Primary practice address
529 Jasmine St
Omak WA 98841-9589
Phone: (509) 826-1600
Fax: (509) 826-3633
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60149531 | Washington |
Profile Details
| NPI number | 1164409637 |
|---|---|
| LBN Legal business name | Fisk, Gregory D |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2005 |
| Last updated | Apr 20th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164409637 | NPPES |
| Washington | Other | 202201 | L & Z |
| Washington | MEDICAID | 8439796 | L & Z |
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