Individual provider · Type 1 NPI

Ellayna Renee Wiedow Avila, PA-C

Surgical Physician Assistant · Chandler, AZ

NPI number 1417435181 Active

Practice location

485 S Dobson Rd Ste 110
Chandler, AZ 85224-5600

Call (480) 728-4470 Map

Fax (480) 728-4499

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X7241 (AZ)

Surgical Physician Assistant: Definition to come...

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About NPI 1417435181

Ellayna Renee Wiedow Avila, PA-C's National Provider Identifier is 1417435181, issued on Aug 3, 2018. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Chandler, AZ. The record was last updated on Dec 5, 2024.