Mirly, Alan K
Mirly, Alan K is an individual health care provider with primary practice located at 2525 Ne 139Th St Ste 220 , Vancouver WA 98686-2719. 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. Mirly, Alan K can be contacted via phone (360) 882-2778.Contact Information
Primary practice address
2525 Ne 139Th St Ste 220
Vancouver WA 98686-2719
Phone: (360) 882-2778
Fax: (360) 604-1616
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA-558 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60997082 | Washington |
Profile Details
| NPI number | 1891780524 |
|---|---|
| LBN Legal business name | Mirly, Alan K |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Dec 9th, 2019 - about 5 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 | 1891780524 | NPPES |
| Washington | MEDICAID | 2143194 | |
| Washington | MEDICAID | 807225300 | |
| Washington | Other | PAWV4 |
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