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JOHNNY VANDIVER, PA

PA

Physician Assistant

NPI: 1629059126IndividualAccepts Medicare

Specialties, Licenses & Credentials

Physician AssistantPrimary

Physician Assistant

Code: 363A00000X

CMS Specialties

Education

OTHER

Class of 1998

Contact & Hours

Address
12233 24TH STREET
JOINT BASE LEWIS MCHORD, WA 98433

Quick Facts

NPI
1629059126
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
1
Locations
1
Years in Practice
28

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