Provider Demographics
NPI:1063025260
Name:KENDALL, ERIN K (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:K
Last Name:KENDALL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:K
Other - Last Name:BUCHERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMT, MA-P
Mailing Address - Street 1:9720 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2143
Mailing Address - Country:US
Mailing Address - Phone:206-302-1200
Mailing Address - Fax:
Practice Address - Street 1:9800 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2152
Practice Address - Country:US
Practice Address - Phone:206-302-1200
Practice Address - Fax:877-516-8135
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61231801363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant