Provider Demographics
NPI:1902108723
Name:MURPHY, JOHN KIRK (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KIRK
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 VIRGINIA ST STE 215
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1430
Mailing Address - Country:US
Mailing Address - Phone:206-621-1116
Mailing Address - Fax:206-621-0460
Practice Address - Street 1:1100 VIRGINIA ST STE 215
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1430
Practice Address - Country:US
Practice Address - Phone:206-621-1116
Practice Address - Fax:206-621-0460
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA 10000382363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant