Provider Demographics
NPI:1306957063
Name:HASSLER, DARRELL LYNN (PA-C)
Entity type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:LYNN
Last Name:HASSLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HOSPITAL LOOP
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011-8704
Mailing Address - Country:US
Mailing Address - Phone:509-247-9783
Mailing Address - Fax:509-247-9727
Practice Address - Street 1:11604 W NEWKIRK RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-8909
Practice Address - Country:US
Practice Address - Phone:509-247-9783
Practice Address - Fax:509-247-9727
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003724363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant