Active NPI
David Michael Pastick, PAC
- Medical Physician Assistant
- Vancouver, WA
National Provider Identifier
1477593341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10002264
- Practice address
- 100 E 33Rd St Ste 100
Vancouver, WA 98663-2776 - Phone
- (360) 514-7550
- Fax
- (360) 514-7553
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10002264 | WA | Primary |
Addresses
Primary practice location
100 E 33Rd St Ste 100
Vancouver, WA 98663-2776
Mailing address
PO Box 1600
100 E. 33Rd Street, Suite 100
Vancouver, WA 98668-1600
Phone (360) 514-7550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8131195 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10002264 | WA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477593341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1600",
"address_2": "100 E. 33RD STREET, SUITE 100",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986681600",
"telephone_number": "360-514-7550",
"fax_number": "360-514-7553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E 33RD ST STE 100",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986632776",
"telephone_number": "360-514-7550",
"fax_number": "360-514-7553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTICK",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10002264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8131195",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.