Active NPI
Brandon Alan Swisher, PA-C
- Surgical Physician Assistant
- Bonney Lake, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA10004921
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1042529 | Medicaid | WA |
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
Enrollment records 1
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
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
- Multicare Auburn Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10004921 | WA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Surgical | Current | Accepting new patients |
| Cascade Hernia and Surgical Solutions PS | Current | Accepting new patients | |
| Proliance Surgeons, Inc., P.S. | Physician Assistant | Current | 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.
-
- Surgery Physician
- Puyallup, WA
- NPI 1174725402
-
- Emergency Medicine Physician
- Tacoma, WA
- NPI 1013490507
-
- Family Medicine Physician
- Lakewood, WA
- NPI 1043513435
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Surgery Physician
- Puyallup, WA
- NPI 1477616936
-
- Orthopaedic Surgery Physician
- Puyallup, WA
- NPI 1952399123
Physician Assistant
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Auburn, WA
- NPI 1255327201
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.