Washburn, Ethan D

Washburn, Ethan D is an individual health care provider with primary practice located at 1550 S Pioneer Way , Moses Lake WA 98837-4613. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Washburn, Ethan D can be contacted via phone (509) 793-9770.

Contact Information

Primary practice address
1550 S Pioneer Way Moses Lake WA 98837-4613
Phone: (509) 793-9770
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA60120190 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60120190 Washington

Profile Details

NPI number 1003142936
LBN Legal business name Washburn, Ethan D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2009
Last updated Nov 21st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003142936 NPPES
Washington MEDICAID 2004464

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