JESSE R SHAFFER (NPI# 1053647966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053647966 |
| Entity Type | Individual |
| Full Name | JESSE R SHAFFER |
| Credential | PA-C |
| Practice Address |
1615 Delaware St Longview WA 98632-2367 |
| Mailing Address |
Po Box 3002 Longview WA 98632-0302 |
| Practice Telephone | 3605013500 |
| Practice Fax Number | 3605013555 |
| Mailing Telephone | 3605013500 |
| Mailing Fax Number | 3605013555 |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60108805 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1615 DELAWARE ST |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| 1881100808 | Mackenzie Cole | Physician Assistant | 323 E Hawkins Pkwy Ste A, Longview, TX 75605-8162 | 2017-12-28 |
| 1629097621 | Christine L Matthews | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2310 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780153536 | Patricia Dorian | Physician Assistant | 2950 Squalicum Pkwy Ste B, Bellingham, WA 98225-1857 | 2018-11-21 |
| 1851875561 | Sarah Gene Soloff | Physician Assistant | 9730 3rd Ave Ne Ste 201, Seattle, WA 98115-2023 | 2018-09-18 |
| 1104308394 | Johnny Thanh Nguyen | Physician Assistant | 1135 116th Ave Ne Ste 605, Bellevue, WA 98004-4697 | 2018-09-04 |
| 1558843201 | Stefanie Eller | Physician Assistant | 532 Cedar Wood Ln, Wenatchee, WA 98801-2476 | 2018-08-29 |
| 1861987992 | Lillian Baldwin Bourret | Physician Assistant | 6317 Linden Ave N, Seattle, WA 98103-5658 | 2018-07-01 |
| 1417446758 | Janelle Elizabeth Becker | Physician Assistant | 11511 Canterwood Blvd Nw Ste 205, Gig Harbor, WA 98332 | 2018-05-02 |
| 1982058418 | Ray Johnson | Physician Assistant | 4446 88th Ave Se, Mercer Island, WA 98040 | 2016-04-21 |
| 1073990651 | Laura Skanse | Physician Assistant | 12303 Ne 130th Ln #500, Kirkland, WA 98034 | 2015-05-02 |
| 1104231893 | Amber Elaine Deck | Physician Assistant | 20307 67th Ave E, Spanaway, WA 98387-5600 | 2014-06-22 |
| 1043535024 | Pamela Baird | Physician Assistant | 2016 16th Ave East, Seattle, WA 98112-5260 | 2010-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.