Justin Mandeville, PA-C is a
Physician Assistant based in Yelm, Washington. Justin Mandeville is licensed to practice in * (Not Available) (license number ) and his current practice location is
9391 Prarrie Wind St, Yelm, Washington. He can be reached at his office (for appointments etc.) via phone at
(517) 667-8729.
NPI number for Justin Mandeville is 1073019550 and his current mailing address is Bldg 11582 C Street, Okubo Clinic, Jblm, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1073019550.
Provider's Profile
| Full Name | Justin Mandeville |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 9391 Prarrie Wind St, Yelm, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073019550
- Provider Enumeration Date: 04/03/2018
- Last Update Date: 07/25/2023
Medical Identifiers
Medical identifiers for Justin Mandeville such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073019550 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Mandeville is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Mandeville, PA-C
Bldg 11582 C Street, Okubo Clinic,
Jblm, WA 98433
Ph: () - | Justin Mandeville, PA-C
9391 Prarrie Wind St,
Yelm, WA 98597
Ph: (517) 667-8729 |
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