Active NPI
A Chancellor Pell, PA-C
- Physician Assistant
- Monroe, WA
National Provider Identifier
1013968254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10003136
- Practice address
- 19200 N Kelsey St
Monroe, WA 98272-1431 - Phone
- (360) 794-7994
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003136 | WA | Primary |
Addresses
Primary practice location
19200 N Kelsey St
Monroe, WA 98272-1431
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8324121 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1013968254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "866-366-2983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19200 N KELSEY ST",
"city": "MONROE",
"state": "WA",
"postal_code": "982721431",
"telephone_number": "360-794-7994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELL",
"first_name": "A",
"middle_name": "CHANCELLOR",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10003136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8324121",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.