Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JON DERIK MORTENSEN, PAC
ActiveJON DERIK MORTENSEN, PAC is a Medical Physician Assistant healthcare provider located in LAKEWOOD, Washington. NPI 1407930456 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · LAKEWOOD, WA
Registration Details
- NPI Number
- 1407930456
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 25, 2006 (19.804974027161 yrs)
- Last Updated
- Jun 14, 2012
- License
-
PA10005073 (WA)
Practice Information
- Address
-
10510 GRAVELLY LAKE DR.COMMUNITY HEALTH CARE - LAKEWOOD CLINICLAKEWOOD, WA, 98499Browse WA providers · Browse ZIP 98499
- Phone
- 2535897030
- Fax
- 2535897033
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in LAKEWOOD, WA
| Name | Credential | NPI |
|---|---|---|
| ARMANDO J GARCIA | PA-C | 1619997657 |
| MRS. MARGARET COLLEEN GRAM | PA-C | 1023227972 |
| CARA J ANTOL | PA-C | 1275783920 |
| JULIA ELIZABETH CATHCART-CHANG | — | 1174831440 |
| TORI GRACE FRANKLIN | PA | 1992088991 |
| MRS. PERRI CONNELL | PA-C | 1932597523 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.