Individual provider · Type 1 NPI
Glenn Andrew Mahoney, PAC
Medical Physician Assistant · Lake Stevens, WA
NPI number
1841263365
Active
Practice location
8910 Vernon Road
Lake Stevens, WA 98258
Fax (425) 335-5145
Mailing address
3901 Hoyt Avenue
Everett, WA 98201
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | PAC942 (NV) |
| Medical Physician Assistant | 363AM0700X | PA60042438 (WA) |
| Medical Physician Assistant Primary | 363AM0700X | 12451 (GA) |
Medical Physician Assistant: Definition to come...
Another provider at this address
About NPI 1841263365
Glenn Andrew Mahoney, PAC's National Provider Identifier is 1841263365, issued on Feb 8, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lake Stevens, WA. The record was last updated on Sep 17, 2024.