Provider Demographics
NPI:1154085041
Name:COVILLO, ABBY MAE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:MAE
Last Name:COVILLO
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1326 N STANFORD LN
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-5034
Practice Address - Country:US
Practice Address - Phone:509-755-6760
Practice Address - Fax:509-755-6761
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2025-07-23
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Provider Licenses
StateLicense IDTaxonomies
WAPA61367905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant