IndividualActive
Jason Phillips, PA-C
NPI 1992878946 · Surgical Physician Assistant · Moscow, ID
Provider details
- NPI number
- 1992878946
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA-1735 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2301 W a St
Moscow, ID 83843-4038
Phone: (208) 883-1135
Fax: (208) 892-0174
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 8007
Moscow, ID 83843-0507
Registry dates
- Enumerated
- 2006-11-16
- Last updated
- 2026-02-27
- Certified
- 2026-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.