MRS. TINA FAITH DERR PA-C
NPI 1093797961
Physician Assistant in Dayton, WA

Q: What is Tina Derr's NPI number?

The NPI number for Tina Derr is 1093797961. It was assigned to this individual provider in the NPPES registry on November 16, 2005.

Q: What is Tina Derr's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tina Derr was last updated on March 7, 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.

Active since November 16, 2005

1012 SOUTH THIRD STREET, COLUMBIA FAMILY CLINIC, DAYTON, WA 99328(509) 382-3200(509) 382-2748 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Tina Faith Derr Pa-c NPPES

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

MRS. TINA FAITH DERR PA-C (NPI 1093797961) is an individual physician assistant in Dayton, Washington, licensed in Washington (PA60426271) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1093797961

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. TINA FAITH DERRCredential: PA-C

Location Address1012 SOUTH THIRD STREET, COLUMBIA FAMILY CLINICDayton, WA 99328

Mailing Address1012 South Third StreetDayton, WA 99328 · (509) 382-2531 · Fax (509) 382-9359

Phone(509) 382-3200

Fax(509) 382-2748

Sole ProprietorNo

Enumeration DateNovember 16, 2005

Last NPPES UpdateMarch 7, 2023

✔ NPI 1093797961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in WA · PA60426271✔ Licensed in NM · PA2004-0030

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.

1012 SOUTH THIRD STREET, Dayton, WA 99328

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Other Identifiers 2

OtherPA2004-0030NM · Pa License

Medicaid83320253NM

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSAY A MICHAELSON ARNP

Nurse Practitioner (Family)