Dennis Phrasavath, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

401 15TH Ave SE
Puyallup, WA 98372-3715

Phone

(253) 697-4000

NPI assigned

May 15, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063869535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 BEACON AVE S # 403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981445816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723715",
            "telephone_number": "253-697-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056366",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-2178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHRASAVATH",
        "first_name": "DENNIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.