Provider Demographics
NPI:1386789410
Name:ALVITRE, JOHN JEFFREY (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JEFFREY
Last Name:ALVITRE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1617 KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-9789
Mailing Address - Country:US
Mailing Address - Phone:253-583-4656
Mailing Address - Fax:253-964-2315
Practice Address - Street 1:2 1 CAVALRY 4 2 ID 3RD DIVISION DRIVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98433
Practice Address - Country:US
Practice Address - Phone:253-966-4098
Practice Address - Fax:253-966-4098
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant