Individual provider Active NPI

Olesya Mykulyn, PA-C

  • Physician Assistant
  • Federal Way, WA
National Provider Identifier
1053848119
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60725218 Issued in WA
Practice address
31405 18TH Ave S
Federal Way, WA 98003-5433
Phone
(253) 681-6600
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60725218 WA Primary

Addresses

Primary practice location

31405 18TH Ave S
Federal Way, WA 98003-5433

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (253) 681-6626

Other practice location 1

11307 Bridgeport Way SW Ste 217
Lakewood, WA 98499-3024
Phone (253) 985-6134

Other names 1

  • Olesya Palosh Former name

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
I20170707002081 WA Practitioner - Physician Assistant 7517236458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

31405 18TH Ave S
Federal Way, WA 98003-5433
Phone (253) 681-6600

8720 14TH Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60725218WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Jun 8, 2017 Accepting new patients
Sea Mar Community Health Centers CurrentSince Jun 8, 2017 Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

31405 18th Ave S
Federal Way, WA 98003
Phone (253) 681-6600

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1053848119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "253-681-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31405 18TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035433",
            "telephone_number": "253-681-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11307 Bridgeport Way SW Ste 217",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984993024",
            "country_code": "US",
            "telephone_number": "253-985-6134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYKULYN",
        "first_name": "OLESYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60725218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLESYA",
            "last_name": "PALOSH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.