Provider Demographics
NPI:1174532980
Name:WASHKO, PATRICIA JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:WASHKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27443 MOUNTAIN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-6116
Mailing Address - Country:US
Mailing Address - Phone:303-838-6791
Mailing Address - Fax:
Practice Address - Street 1:83000 WEST 38TH AVENUE
Practice Address - Street 2:
Practice Address - City:WHEATRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:303-425-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO695363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07006950Medicaid
802759Medicare ID - Type Unspecified
CO07006950Medicaid
COC802759Medicare PIN