Stacy Elizabeth Legg, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60739505 Issued in WA

Practice address

700 NE 87TH Ave Ste 280
Vancouver, WA 98664-4896

Phone

(360) 882-2778

Fax

(360) 604-1785

NPI assigned

Oct 27, 2016

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Beaverton Rehab & Specialty Care, LLC

  • Skilled Nursing Facility
  • Beaverton, OR
  • NPI 1366469330
  NPD

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1174075865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8649 MARTIN WAY E",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 280",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "STACY",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60739505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Salmon Creek Hospital
• Legacy Salmon Creek Hospital
• Legacy Salmon Creek Hospital
• Legacy Salmon Creek Im
• Nicole Legeyt, BSN
• Jacqueline Ameretta Lee Leggett, BS, CDPT
• Legionary Mental Health PLLC
• Kristin Brooke Legrand, DO
• Tiffany Ruth Legree
• William James Lehan III, LPN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.