IndividualActive
Alan Mirly, PA
NPI 1891780524 · Physician Assistant · Vancouver, WA
Provider details
- NPI number
- 1891780524
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- PA-558 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2525 Ne 139th St Ste 220
Vancouver, WA 98686-2719
Phone: (360) 882-2778
Fax: (360) 604-1616
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 4825
Portland, OR 97208-4825
Registry dates
- Enumerated
- 2005-09-19
- Last updated
- 2019-12-09
- Certified
- 2019-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.