JUSTIN MANDEVILLE PA-C
NPI 1073019550
Physician Assistant in Yelm, WA

Active since April 03, 2018
9391 PRARRIE WIND ST, YELM, WA 98597(517) 667-8729 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Justin Mandeville Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN MANDEVILLE PA-C (NPI 1073019550) is an individual physician assistant in Yelm, Washington and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1073019550
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJUSTIN MANDEVILLECredential: PA-C
Location Address9391 PRARRIE WIND STYelm, WA 98597
Mailing AddressBldg 11582 C Street, Okubo ClinicJblm, WA 98433
Sole ProprietorNo
Enumeration DateApril 3, 2018
Last NPPES UpdateJuly 25, 2023
NPPES CertifiedJuly 24, 2023
NPI 1073019550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
9391 PRARRIE WIND ST, Yelm, WA 98597

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Mandeville's NPI number?

The NPI number for Justin Mandeville is 1073019550. It was assigned to this individual provider in the NPPES registry on April 3, 2018.

Where is Justin Mandeville located?

Justin Mandeville practices at 9391 Prarrie Wind St, Yelm, WA 98597. The listed phone number is (517) 667-8729.

What is Justin Mandeville's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Justin Mandeville was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.