Individual provider Active NPI

Brandon Alan Swisher, PA-C

  • Surgical Physician Assistant
  • Bonney Lake, WA
National Provider Identifier
1013949452
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10004921 Issued in WA
Practice address
10004 204TH Ave E
#1200
Bonney Lake, WA 98391-6539
Phone
(253) 848-5951
Fax
(253) 845-7073
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004921 WA
Surgical Physician Assistant 363AS0400X PA10004921 WA Primary

Addresses

Primary practice location

10004 204TH Ave E
#1200
Bonney Lake, WA 98391-6539

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Other practice location 1

1411 4th Ave
Seattle, WA 98101-2249
Phone (253) 271-9720

Other practice location 2

3801 5th St SE Ste 110
Puyallup, WA 98374-2106
Phone (253) 845-9585

Other identifiers 1

IdentifierTypeStateIssuer
1042529MedicaidWA

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
I20060224000087 WA Practitioner - Physician Assistant 7911913264 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Hernia and Surgical Solutions PSGroup PAC ID 3577663665, 3 clinicians

Practice addresses (Care Compare)

208 17TH Ave SE
Suite 201
Puyallup, WA 98372-4515
Phone (253) 840-1999

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004921WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Surgical CurrentSince Apr 1, 2019 Accepting new patients
Cascade Hernia and Surgical Solutions PS CurrentSince Mar 15, 2014 Accepting new patients
Proliance Surgeons, Inc., P.S. Physician Assistant CurrentSince Apr 1, 2019 Accepting new patients

Locations

3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585

208 17th Ave SE
#201
Puyallup, WA 98372
Phone (253) 840-1999

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 7

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 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1013949452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E",
            "address_2": "#1200",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916539",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012249",
            "country_code": "US",
            "telephone_number": "253-271-9720",
            "fax_number": "253-212-3372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 5th St SE Ste 110",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983742106",
            "country_code": "US",
            "telephone_number": "253-845-9585",
            "fax_number": "253-848-1126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWISHER",
        "first_name": "BRANDON",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004921",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042529",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.