Individual provider Active NPI

Marisol Salazar

  • Medical Physician Assistant
  • Lakewood, WA
National Provider Identifier
1003396953
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61013951 Issued in WA
Practice address
10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036
Phone
(253) 597-4550
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61013951 WA Primary

Addresses

Primary practice location

10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036

Mailing address

1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone (253) 597-4550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000863 WA Practitioner - Physician Assistant 3870914112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health CareGroup PAC ID 1850201559, 72 clinicians

Practice addresses (Care Compare)

10510 Gravelly Lake Dr SW
Lake Wood Clinic
Lakewood, WA 98499-5036
Phone (253) 589-7030

134 188TH St S
Spanaway, WA 98387-4618
Phone (253) 847-2304

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care CurrentSince Dec 23, 2019 Accepting new patients
Community Health Care CurrentSince Dec 23, 2019 Accepting new patients
Hilltop Regional Health Center Student in an Organized Health Care Education/Training Program Past Accepting new patients
Community Health Care Past Accepting new patients

Locations

134 188th St S
Spanaway, WA 98387
Phone (253) 847-2304

1202 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 441-4742

1148 Broadway
Ste 100
Tacoma, WA 98402
Phone (253) 441-4742

1708 E 44th St
Tacoma, WA 98404
Phone (253) 471-4553

11225 Pacific Ave S
Tacoma, WA 98444
Phone (253) 536-2020

10510 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 589-7030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: marisol.salazarpac.d2.p1@direct.chc-tacoma.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1003396953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-597-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995036",
            "telephone_number": "253-597-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "MARISOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61013951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.