Provider Demographics
NPI:1649708363
Name:HASSELL, ADAM (PA)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HASSELL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:348 N 166TH LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-6100
Mailing Address - Country:US
Mailing Address - Phone:208-284-4438
Mailing Address - Fax:
Practice Address - Street 1:3301 N LITCHFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-3197
Practice Address - Country:US
Practice Address - Phone:623-935-2929
Practice Address - Fax:623-935-3647
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA61228029363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant