Individual provider Active NPI

Emily Rose

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1164244257
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61637718 Issued in WA
Practice address
874 American Pacific Dr
Henderson, NV 89014-8800
Phone
(702) 777-8687
NPI assigned
Oct 29, 2024
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 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 PA61637718 WA Primary

Addresses

Primary practice location

874 American Pacific Dr
Henderson, NV 89014-8800

Mailing address

PO Box 10742
Bainbridge Island, WA 98110-0742

Other practice location 1

1990 Hospital Dr Ste 200
Sedro Woolley, WA 98284-9315
Phone (360) 856-8800

Other practice location 2

1990 Hospital Dr Ste 110
Sedro Woolley, WA 98284-9315
Phone (360) 856-8830

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
I20250507001774 WA Practitioner - Physician Assistant 9830616432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians
Peacehealth Medical Group - Sedro WoolleyGroup PAC ID 1456584036, 55 clinicians

Practice addresses (Care Compare)

1017 20TH St
Anacortes, WA 98221-2505
Phone (360) 564-8695

1990 Hospital Dr
Suite 200
Sedro Woolley, WA 98284-9315
Phone (360) 856-8810

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61637718WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Aug 9, 2025 Accepting new patients
Peacehealth CurrentSince Aug 9, 2025 Accepting new patients

Locations

1017 20th St
Anacortes, WA 98221
Phone (360) 424-7041

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

835 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 755-0641

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: erose691006@direct.peacehealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1164244257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10742",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981100742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 AMERICAN PACIFIC DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890148800",
            "telephone_number": "702-777-8687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Hospital Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982849315",
            "country_code": "US",
            "telephone_number": "360-856-8800",
            "fax_number": "360-714-2520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 Hospital Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982849315",
            "country_code": "US",
            "telephone_number": "360-856-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61637718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.