Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacie Anna Mundahl, PA-C

Individual provider Physician Assistant · NPI 1134751902

Jacie Anna Mundahl, PA-C is a Physician Assistant in Salt Lake City, Utah. Qualified in 2019, 7 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
7
Licensed in
UT
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8TH Ave C St E 80
Salt Lake City, UT 84143-0001
Phone: (801) 408-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11609094-1206 (UT)

Record details

NPI number1134751902
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 10, 2020
Last updated in NPPESFebruary 10, 2020
Certification dateFebruary 10, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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