Individual provider Active NPI

Laura J. Skanse, PA-C

  • Surgical Physician Assistant
  • Everett, WA
National Provider Identifier
1073990651
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
60616440 Issued in WA
Practice address
1100 Pacific Ave Ste 300
Everett, WA 98201-4261
Phone
(425) 339-2433
Fax
(425) 339-8273
NPI assigned
May 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 60616440 WA Primary

Addresses

Primary practice location

1100 Pacific Ave Ste 300
Everett, WA 98201-4261

Mailing address

1100 Pacific Ave Ste 300
Everett, WA 98201-4261
Phone (425) 339-2433

Other practice location 1

19200 N Kelsey St
Monroe, WA 98272-1431
Phone (425) 339-2433

Other identifiers 1

IdentifierTypeStateIssuer
2050607MedicaidWA

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
I20160129002377 WA Practitioner - Physician Assistant 8921189556 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seattle Childrens HospitalGroup PAC ID 9032021050, 113 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 987-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60616440WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Feb 7, 2023 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Aug 1, 2020 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Mar 15, 2021 Accepting new patients
Seattle Children'S Hospital CurrentSince Feb 7, 2023 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Mar 15, 2021 Accepting new patients
King County Public Hospital District No 2 CurrentSince Jan 6, 2016 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Jan 6, 2016 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1100 Pacific Ave
Ste 300
Everett, WA 98201
Phone (425) 337-7000

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

12303 NE 130th Ln
Ste 225
Kirkland, WA 98034
Phone (425) 899-3890

12303 NE 130th Ln
Ste 500
Kirkland, WA 98034
Phone (425) 899-4280

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: lskanse219201@direct.seattlechildrens.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1073990651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC AVE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014261",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC AVE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014261",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19200 N Kelsey St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982721431",
            "country_code": "US",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKANSE",
        "first_name": "LAURA",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "60616440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2050607",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.