Individual provider Active NPI

Linh My Quan, PAC

  • Medical Physician Assistant
  • Spokane, WA
National Provider Identifier
1063447068
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61135043 Issued in WA
Practice address
212 E Central Ave Ste 245
Spokane, WA 99208-6289
Phone
(509) 489-2600
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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 PA61135043 WA
Medical Physician Assistant 363AM0700X PA61135043 WA Primary

Addresses

Primary practice location

212 E Central Ave Ste 245
Spokane, WA 99208-6289

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
2185037MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120924000311 GA Practitioner - Physician Assistant 7113175738
I20211006001276 WA Practitioner - Physician Assistant 7113175738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

212 E Central Ave
Spokane, WA 99208-6289

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-0111

Hospital & facility affiliations

  • Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006513GAMDSpeech-Language Pathologist
PA61135043WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 1, 2023 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

212 E Central Ave
Ste 245
Spokane, WA 99208
Phone (509) 252-1977

16528 E Desmet Ct
Ste A2200
Spokane Valley, WA 99216
Phone (509) 489-2600

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 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1063447068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE STE 245",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086289",
            "telephone_number": "509-489-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "LINH",
        "middle_name": "MY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61135043",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61135043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2185037",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.