Provider Demographics
NPI:1588969141
Name:MCNAMARA, ASHLEY T (PA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:T
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:LH
Other - Last Name:TUTWILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-778-6527
Mailing Address - Fax:303-733-1288
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-778-6527
Practice Address - Fax:303-733-1288
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004418363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COA108528Medicare UPIN