SIMON MENDOZA MORENO (NPI# 1902298987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902298987 |
| Entity Type | Individual |
| Full Name | SIMON MENDOZA MORENO |
| Credential | PA-C |
| Practice Address |
900 Eastmont Ave East Wenatchee WA 98802-6602 |
| Mailing Address |
600 Orondo Ave Ste 1 Wenatchee WA 98801-2800 |
| Practice Telephone | 5098849000 |
| Mailing Telephone | 5096626000 |
| Mailing Fax Number | 5096644590 |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2020-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60672657 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 Orondo Ave, Ste 1, Wenatchee, WA 988012800 | 5096626000 | 5096644590 |
| 6240 Tacoma Mall Blvd Ste 101, Tacoma, WA 984096819 | 2532719720 | 2532123372 |
| Street Address |
900 EASTMONT AVE |
| City | EAST WENATCHEE |
| State | WA |
| Zip Code | 98802-6602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346231354 | Malcolm A Butler | Family Medicine | 900 Eastmont Ave, East Wenatchee, WA 98802-6602 | 2005-10-31 |
| 1134403678 | Casey S Wyatt | Physician Assistant | 900 Eastmont Ave, East Wenatchee, WA 98802-6602 | 2011-10-03 |
| 1205860079 | Lorena G Boyd | Registered Nurse | 900 Eastmont Ave, East Wenatchee, WA 98802-6602 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699215483 | Nicole Christinia Johnson | Dietitian, Registered | 50 Simon Street Se Suite A, East Wenatchee, WA 98802 | 2017-02-28 |
| 1013394337 | Robbie Bowling | Counselor | 636 Valley Mall Parkway, Suite 200, East Wenatchee, WA 98802 | 2015-05-06 |
| 1437572203 | Aging & Adult Care of Central Washington | Case Management | 270 9th Street Ne Suite 100, East Wenatchee, WA 98802 | 2014-01-29 |
| 1417379900 | Kathryn Marie Gallik Maccallum | Occupational Therapist | 1983 Legendary Ln Se, East Wenatchee, WA 98802 | 2014-01-17 |
| 1649606328 | Hilary Kathleen Mann | Massage Therapist | 304 Grant Road, Suite #1, East Wenatchee, WA 98802 | 2013-09-25 |
| 1932544988 | Sound Oxygen Service, Inc. | Durable Medical Equipment & Medical Supplies | 640 Valley Mall Pkwy Ste B, East Wenatchee, WA 98802 | 2013-05-03 |
| 1346519329 | Lindsay N Grode | Massage Therapist | 667 Grant Road, Suite 3, East Wenatchee, WA 98802 | 2011-12-21 |
| 1952601726 | Lizette Corral | Massage Therapist | 2434 Bellanca St, East Wenatchee, WA 98802 | 2010-10-27 |
| 1548415615 | Ashley Cristine Neumann | Counselor | 558 Morning View Ave, Ste 100, East Wenatchee, WA 98802 | 2008-11-17 |
| 1962528950 | Diana Maria Villalobos | Counselor | 220 Eastmont Ave Childrens Home Society of Washington, Suite B, East Wenatchee, WA 98802 | 2007-03-21 |
| Find all providers in zip 98802 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134403678 | Casey S Wyatt | Physician Assistant | 900 Eastmont Ave, East Wenatchee, WA 98802-6602 | 2011-10-03 |
| 1114072113 | Robert Michael Norman | Physician Assistant | 100 Highline Dr, East Wenatchee, WA 98802-5341 | 2007-01-23 |
| 1962421230 | Katherine M Davies | Physician Assistant | 100 Highline Dr, East Wenatchee, WA 98802-5341 | 2006-07-18 |
| 1891728218 | Anne M Jarmin | Physician Assistant | 100 Highline Dr, East Wenatchee, WA 98802-5341 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
| City | EAST WENATCHEE |
| Zip Code | 98802 |
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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.