CLIFTON VINCENT PHILLIPS PA-C NPI 1699281642

NPI Information

NPI: 1699281642
Provider Name: CLIFTON VINCENT PHILLIPS, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
510 8TH AVE NE STE 310
ISSAQUAH, WA
ZIP 98029
Phone: (425) 454-3938
Get Directions

Clifton Vincent Phillips, PA-C is a surgical physician assistant in Issaquah, WA with 6 years of experience. Clifton Vincent Phillips, PA-C NPI is 1699281642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

510 8TH AVE NE STE 310
ISSAQUAH, WA
ZIP 98029-436
Phone: (425) 454-3938
Fax: (425) 392-3561

The NPI 1699281642 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/28/2017 and was last updated on 8/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA60895418	WASHINGTON	No
2	363AS0400X	Physician Assistant	Surgical	PA60895418	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2113108	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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