Johnny Ray Vandiver, PA
Johnny Ray Vandiver, PA is a Physician Assistant in Joint Base Lewis McHord, Washington. Qualified in 1998, 28 years ago. Practices with Tanana Chiefs Conference, a 149-clinician group and accepts Medicare assignment.
- Years since qualifying
- 28
- In the registry since
- 2005
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
12233 24th StJoint Base Lewis McHord, WA 98433
Phone: (253) 477-5734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1629059126 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | November 10, 2005 |
| Last updated in NPPES | November 7, 2012 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 1998 (28 years in practice) |
| Group practice | Tanana Chiefs Conference — 149 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |