Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John Russell Prentice, PA-C

Individual provider Physician Assistant · NPI 1497736110

John Russell Prentice, PA-C is a Physician Assistant in Vancouver, Washington. Licensed in West Virginia. Registered with an NPI since 2005.

Licensed in
WV
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

11808 NE Fourth Plain Rd Ste A
Vancouver, WA 98682-5524
Phone: (360) 253-6947
Fax: (360) 256-9547
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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 PA10002522 (WV)

Record details

NPI number1497736110
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 9, 2005
Last updated in NPPESJuly 13, 2026
Mailing address11808 Ne Fourth Plain Rd, Suite A, Vancouver, WA 98682-5524

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