1. Home
  2. Directory
  3. Washington
  4. Moses Lake
  5. Physician Assistant
  6. NPI Profile

MR. LEROY KEITH VAN DYKE PA
NPI 1306842307
Physician Assistant in Moses Lake, WA

Active since June 23, 2005
3322 ROAD N NE, MOSES LAKE, WA 98837(509) 793-9051(509) 766-8585 Get Directions Write a Review

NPPES record last updated: January 18, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Leroy Keith Van Dyke Pa NPPES

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

MR. LEROY KEITH VAN DYKE PA (NPI 1306842307) is an individual physician assistant in Moses Lake, Washington, licensed in Washington (PA10003296) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1306842307
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. LEROY KEITH VAN DYKECredential: PA
Location Address3322 ROAD N NEMoses Lake, WA 98837-9505
Mailing Address3322 Road N NeMoses Lake, WA 98837-9505 · (509) 793-9051 · Fax (509) 766-8585
Phone(509) 793-9051
Fax(509) 766-8585
Sole ProprietorYes
Enumeration DateJune 23, 2005
Last NPPES UpdateJanuary 18, 2024
✔ NPI 1306842307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WA · PA10003296
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.
3322 ROAD N NE, Moses Lake, WA 98837
Open in Google Maps ↗

Other Identifiers 1

Medicaid8421323WA

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 Leroy Van Dyke's NPI number?

The NPI number for Leroy Van Dyke is 1306842307. It was assigned to this individual provider in the NPPES registry on June 23, 2005.

Where is Leroy Van Dyke located?

Leroy Van Dyke practices at 3322 Road N NE, Moses Lake, WA 98837. The listed phone number is (509) 793-9051.

What is Leroy Van Dyke'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 Leroy Van Dyke was last updated on January 18, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.