TREVOR JACKMAN (NPI# 1285286534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285286534 |
| Entity Type | Individual |
| Full Name | TREVOR JACKMAN |
| Credential | PA-C |
| Practice Address |
939 Caroline St Port Angeles WA 98362-3997 |
| Practice Telephone | 3604177000 |
| Mailing Telephone | 3604177000 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 61104032 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 730 E 590 S, Ivins, UT 847385089 | 7608997751 |
| Street Address |
939 CAROLINE ST |
| City | PORT ANGELES |
| State | WA |
| Zip Code | 98362-3997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739829 | Pamela J Bundy | Anesthesiology | 939 Caroline St, Port Angeles, WA 98362-3909 | 2005-06-10 |
| 1508463902 | Amy Kalisek | Nurse Practitioner | 939 Caroline St, Port Angeles, WA 98362-3997 | 2020-10-08 |
| 1376155721 | Tierra Renee Thompson | Social Worker | 939 Caroline St, Port Angeles, WA 98362-3909 | 2020-08-18 |
| 1194344333 | Kassandra Simmons Yager | Nurse Practitioner | 939 Caroline St, Port Angeles, WA 98362-3909 | 2020-04-08 |
| 1295391357 | Kelly Michelle Mann | Nurse Practitioner | 939 Caroline St, Port Angeles, WA 98362-3997 | 2019-05-14 |
| 1023580461 | Fallon Ann Clancy | Physician Assistant | 939 Caroline St, Port Angeles, WA 98362-3997 | 2018-12-26 |
| 1548740210 | King County Public Hospital District No. 2 | Neurological Surgery | 939 Caroline St, Port Angeles, WA 98362 | 2018-08-21 |
| 1619460185 | Emily Allison Allen | Speech-Language Pathologist | 939 Caroline St, Port Angeles, WA 98362-3997 | 2018-06-10 |
| 1093215121 | Elizabeth Schuerman | Dietitian, Registered | 939 Caroline St, Port Angeles, WA 98362-3909 | 2018-02-15 |
| 1457872251 | Heidi Byers | Registered Nurse | 939 Caroline St, Port Angeles, WA 98362-3909 | 2017-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831735778 | Jayme Marie Williams | Technician | 518 S. Liberty St., Port Angeles, WA 98362 | 2019-11-26 |
| 1780229559 | Barbara Amsler Nutrition, Pllc | Dietitian, Registered | 320 E. 5th St., Port Angeles, WA 98362 | 2019-11-15 |
| 1902315005 | Barbara Amsler | Nutritionist | 116 S. Ennis St, Port Angeles, WA 98362 | 2017-09-21 |
| 1134659667 | Janet Li Hanson | Registered Nurse | 532 South Alder Lane, Port Angeles, WA 98362 | 2017-06-18 |
| 1790220192 | Monica Kay Henry | Massage Therapist | 102 1/2 East 1st Street Suite #7, Port Angeles, WA 98362 | 2016-12-21 |
| 1124491725 | Gabrielle Carter | Naturopath | 1126 Columbia St, Port Angeles, WA 98362 | 2015-11-04 |
| 1912301185 | Danya Lyn Davis | Massage Therapist | 106 W. Lauridsen Blvd., Port Angeles, WA 98362 | 2014-10-17 |
| 1528470861 | Richard Dean Thorson | Orthopaedic Surgery | 719 S. Laurel St, Olympic Chiropractic, Port Angels, WA 98362 | 2014-05-21 |
| 1780001743 | Dr Adam Cramer Pllc | Clinic/Center | 104 W. 3rd St, Port Angeles, WA 98362 | 2014-03-27 |
| 1588089189 | Melanie Mccaughan | Counselor | 933 E First St, Port Angeles, WA 98362 | 2014-02-19 |
| Find all providers in zip 98362 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053969451 | Kari Ann Walen | Physician Assistant | 4407 Fairmont Ave, Port Angeles, WA 98363 | 2019-08-28 |
| 1942816186 | Katie Michelle Armbruster | Physician Assistant | 433 E 8th St, Port Angeles, WA 98362-6219 | 2020-09-22 |
| 1427515782 | Bradley Kyle Rodell | Physician Assistant | 240 W Front St, Port Angeles, WA 98362-2609 | 2019-02-22 |
| 1023580461 | Fallon Ann Clancy | Physician Assistant | 939 Caroline St, Port Angeles, WA 98362-3997 | 2018-12-26 |
| 1437625753 | Erik C Farley | Physician Assistant | 907 Georgiana St, Port Angeles, WA 98362-3911 | 2018-10-15 |
| 1164946299 | Paul Townsend | Physician Assistant | 433 E 8th St, Port Angeles, WA 98362-6219 | 2017-07-31 |
| 1083147342 | Melani Maxfield | Physician Assistant | 907 Georgiana St, Port Angeles, WA 98362-3911 | 2017-04-04 |
| 1376991406 | Frank Lester Boyd | Physician Assistant | 907 Georgiana St, Port Angeles, WA 98362-3911 | 2016-05-31 |
| 1114374667 | Sara Steffen | Physician Assistant | 907 Georgiana St, Port Angeles, WA 98362-3911 | 2016-05-14 |
| 1194196857 | Meredith June Karns | Physician Assistant | 939 Caroline St, Port Angeles, WA 98362-3909 | 2015-10-07 |
| Find all providers in PORT ANGELES | ||||
| City | PORT ANGELES |
| Zip Code | 98362 |
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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.