Miguel L. Medrano, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA60464236 Issued in WA

Practice address

701 Dale Ave
Benton City, WA 99320-5250

Phone

(509) 588-4075

Fax

(509) 588-4197

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1639111586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 MEMORIAL ST",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501524",
            "telephone_number": "509-786-2222",
            "fax_number": "509-786-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DALE AVE",
            "city": "BENTON CITY",
            "state": "WA",
            "postal_code": "993205250",
            "telephone_number": "509-588-4075",
            "fax_number": "509-588-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "MIGUEL",
        "middle_name": "L.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16427",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "OA60464236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiona-Benton City School
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• Walburga S Martin, M.D.
• Toni Diane Microulis, ARNP
• NS Khurana DMD PLLC
• Michelle Marie Pehrson, FNP-C
• Steve Peters, LMHC
• Brigette Deann Phillips, CDP

• Physician Assistant in Benton City, WA
• Providers in Benton City, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.