Provider Demographics
NPI:1902308950
Name:GALLAWAY, SKYLER ANTHONY (PA-C)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:ANTHONY
Last Name:GALLAWAY
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 1:8310 W DESCHUTES AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1629
Mailing Address - Country:US
Mailing Address - Phone:509-989-0624
Mailing Address - Fax:
Practice Address - Street 1:320 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2010
Practice Address - Country:US
Practice Address - Phone:406-283-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant