BREANNA LYNN POLK (NPI# 1942725072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942725072 |
Entity Type | Individual |
Full Name | BREANNA LYNN POLK |
Credential | PA-C |
Practice Address |
1724 W Union Ave Tacoma WA 98405-2099 |
Mailing Address |
805 Madison St Ste 901 Seattle WA 98104-1172 |
Practice Telephone | 2538305200 |
Mailing Telephone | 2062648100 |
Enumeration Date | 2017-08-09 |
Last Update Date | 2018-03-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60796887 | WA | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
7308 Bridgeport Way W Ste 201, Lakewood, WA 984998000 | 2535827257 | 2535821617 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407227127 | Breanna Polk | Counselor | 8915 Harry Hines Blvd, Dallas, TX 75235-1717 | 2015-10-08 |
Street Address |
1724 W UNION AVE |
City | TACOMA |
State | WA |
Zip Code | 98405-2099 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891761177 | Jillanna Marie Allen | Specialist/Technologist | 1724 W Union Ave, Suite 100, Tacoma, WA 98405-2099 | 2006-02-27 |
1477742161 | Katie Allison Hadley | Registered Nurse | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2007-10-17 |
1619197449 | Nicholas Scott Harrison | Specialist/Technologist | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2007-04-26 |
1700985611 | John M Blair Jr. | Orthopaedic Surgery | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2006-09-21 |
1750392049 | John H Bargren | Orthopaedic Surgery | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2006-08-11 |
1790726768 | Michael J Martin | Orthopaedic Surgery | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2006-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
Find all providers in zip 98405 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124147087 | Aniko A Szentes | Physician Assistant | 3708 55th St Ne, Tacoma, WA 98422-4571 | 2007-03-29 |
1053324186 | Tommy Lamar Jackson | Physician Assistant | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2006-08-13 |
1396763140 | Jerry John Papson | Physician Assistant | 1812 South J St, Suite 210, Tacoma, WA 98405-4964 | 2006-07-18 |
1215996798 | Jill Tricia Eggersknight | Physician Assistant | Orthopedic Surgery Service, Attn: Mchj-sop, Tacoma, WA 98431-0001 | 2006-03-22 |
1588127062 | Sung Ho Kim | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2019-04-10 |
1215407770 | Monica Huang | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2018-11-27 |
1154803237 | Limary Gonzalez | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2018-09-05 |
1104354190 | Samantha Sokol | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2017-06-02 |
1548662752 | Tomasz Gondek | Physician Assistant | 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | 2014-09-18 |
1740689330 | Jonathon Mcjilton Sr. | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2014-08-19 |
Find all providers in TACOMA |
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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.