Individual ProviderJoseph ProvincePhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 NE Mother Joseph Pl Ste 210, Vancouver, WA 98664-3295(360) 254-6161PECOS EnrollmentBased on the most recent information from CMS, provider Joseph Province is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1558797365Provider TypeIndividualFull NameProvince, JosephCredentialPAGenderMaleSole ProprietorNoEnumeration Date9/25/2013Last Updated10/28/2021Contact InformationPractice LocationPractice Address200 NE Mother Joseph Pl Ste 210, Vancouver, WA 98664-3295Phone(360) 254-6161Fax(360) 449-1146Mailing LocationMailing Address200 NE Mother Joseph Pl Ste 210, Vancouver, WA 98664-3295Phone(360) 254-6161Fax(360) 449-1146Provider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA61208141WashingtonCode363AS0400XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA9107470FloridaCode363AS0400XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA182241OregonProvider IdentifiersIDDescriptionIssuerID010158600DescriptionMedicaidIssuerUnlistedFlorida