David L Oliver, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10001837 Issued in WA

Practice address

1706 Washington Way
Longview, WA 98632-2952

Phone

(360) 423-9580

Fax

(360) 423-6230

NPI assigned

Jun 29, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peacehealth

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  Medicare reassignment NPD
• Kirkpatrick Family Care, PS

  • Medical Specialty Clinic/Center
  • Longview, WA
  • NPI 1447286646
  Medicare reassignment
• Kirkpatrick Family Care, PS

  • Podiatrist
  • Longview, WA
  • NPI 1952746026
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1043217664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1338",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986327785",
            "telephone_number": "360-423-0390",
            "fax_number": "360-577-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 WASHINGTON WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322952",
            "telephone_number": "360-423-9580",
            "fax_number": "360-423-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10001837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND.",
            "identifier": "0158033",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970025814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8936700",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8330896",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Okerson, PHARMD
• Sofya Okronglo, LPN
• Elizabeth Sue Oldham, PT
• Christine Dee Olenski, RDA
• Alexis Oliver, MA, R-AAC
• Brent Olsen
• Elena Vladimirovna Olsen, M.D.
• Kim J. Olsen, RPH
• Patricia Olson
• Shawna Olson, RN

• Physician Assistant in Longview, WA
• Providers in Longview, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.