Individual provider Active NPI

Nissan Armas, PA-C

  • Physician Assistant
  • Shelton, WA
National Provider Identifier
1083223291
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1183036
Practice address
90 SE Klah Che Min Dr
Shelton, WA 98584-9216
Phone
(360) 427-9006
NPI assigned
Jul 24, 2020
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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 1183036 Primary

Addresses

Primary practice location

90 SE Klah Che Min Dr
Shelton, WA 98584-9216

Mailing address

90 SE Klah Che Min Dr
Shelton, WA 98584-9216
Phone (360) 427-9006

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
I20260113002185 WA Practitioner - Physician Assistant 6901382621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nevada School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Squaxin Island TribeGroup PAC ID 2860383122, 5 clinicians

Practice addresses (Care Compare)

90 SE Klah Che Min Dr
Shelton, WA 98584-9216
Phone (360) 427-9006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Squaxin Island Tribe CurrentSince Sep 26, 2025 Accepting new patients

Locations

10 SE Squaxin Ln
Shelton, WA 98584

90 SE Klah Che Min Dr
Shelton, WA 98584
Phone (360) 427-9006

Organizations & group practices 1

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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1083223291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 SE KLAH CHE MIN DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849216",
            "telephone_number": "360-427-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SE KLAH CHE MIN DR",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849216",
            "telephone_number": "360-427-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMAS",
        "first_name": "NISSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-24",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1183036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.