Elijah Telfare, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10002241 Issued in PA

Practice address

500 Lilly Rd NE
Suite 100
Olympia, WA 98506-5195

Phone

(360) 491-4211

Fax

(360) 493-0407

NPI assigned

Mar 21, 2007

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

Other identifiers 1

Other names 1

• Mr. Vincent Telfare Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1124144431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070368",
            "telephone_number": "360-491-8439",
            "fax_number": "360-491-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LILLY RD NE",
            "address_2": "SUITE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065195",
            "telephone_number": "360-491-4211",
            "fax_number": "360-493-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELFARE",
        "first_name": "ELIJAH",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "PA10002241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7066269",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINCENT",
            "last_name": "TELFARE",
            "prefix": "MR.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• April Telan
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• Jace Telloian, M.S. SLP-CF
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• Trista Lynn Martin Tempke
• Corynn Marie Templet
• Jayme Tener

• Surgical Physician Assistant in Olympia, WA
• Providers in Olympia, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.