Kyle Shafer

Physician Assistant · Ilwaco, WA

Individual Active NPI

NPI number 1376172775

Practice location

176 1st Ave N
Ilwaco, WA 98624-9137
Phone
(360) 642-3747

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NPI record

NPI
1376172775
Entity type
Individual (Type 1)
Enumeration date
April 7, 2020
Last updated
July 22, 2020
Certified
July 22, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 61076997 WA

Mailing address

35585 Bella Ridge Loop
Astoria, OR 97103-6630

About Kyle Shafer

Kyle Shafer is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 176 1st Ave N, Ilwaco, WA 98624-9137. The NPI number 1376172775 was assigned on April 7, 2020 and the record was last updated on July 22, 2020.

Kyle Shafer lists a license in the registry: #61076997 (WA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kyle Shafer?

The NPI number is 1376172775.

What is the phone number of Kyle Shafer?

The phone number listed for the practice location is (360) 642-3747.

Where is Kyle Shafer located?

176 1st Ave N, Ilwaco, WA 98624-9137.

What is the taxonomy code for Kyle Shafer?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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