Unknown Individual – Physician Assistant, NPI 1720048234
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1135, 116th Avenue Northeast, Midlakes, Bellevue, King County, Washington, 98004, United States
SUITE 605
BELLEVUE, WA 980044623
Phone: (425) 454-8161
Fax: (425) 454-9304
Type: Location
7583, 44th Avenue Southwest, Delridge, Seattle, King County, Washington, 98136, United States
SEATTLE, WA 981362201
Phone: (206) 938-1856
Fax: (425) 454-9304
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98004)
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