Provider Demographics
NPI:1144475559
Name:MAYFIELD, JOSHUA LEVI (PA-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LEVI
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:LEVI
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA60055375
Mailing Address - Street 1:66 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:POMEROY
Mailing Address - State:WA
Mailing Address - Zip Code:99347-9705
Mailing Address - Country:US
Mailing Address - Phone:509-843-1591
Mailing Address - Fax:509-843-6157
Practice Address - Street 1:66 N 6TH ST
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:WA
Practice Address - Zip Code:99347-9705
Practice Address - Country:US
Practice Address - Phone:509-843-1591
Practice Address - Fax:509-843-6157
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60055375363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA60055375OtherPA LICENSE