Individual provider Active NPI

Khampho Thammavongxay Ohno

  • Medical Physician Assistant
  • Auburn, WA
National Provider Identifier
1174808117
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-84 Issued in GU
Practice address
4238 Auburn Way N
Auburn, WA 98002-1311
Phone
(253) 444-0106
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 60250454 WA
Medical Physician Assistant 363AM0700X PA-84 GU Primary

Addresses

Primary practice location

4238 Auburn Way N
Auburn, WA 98002-1311

Mailing address

4238 Auburn Way N
Auburn, WA 98002-1311
Phone (253) 444-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120201000528 GU Practitioner - Physician Assistant 6709043821 Reassigns benefits to 1 organization
I20260618003686 WA Practitioner - Physician Assistant 6709043821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Conference Corp of SdaGroup PAC ID 6608777628, 52 clinicians

Practice addresses (Care Compare)

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 60250454WAMDPhysician Assistant
PA-84GUMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Jan 4, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khampho.ohno.1@31775.direct.athenahealth.com
  • Direct secure messaging: khampho.ohno@adventistclinic.directbygreenway.com

Organizations & group practices 2

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1174808117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4238 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980021311",
            "telephone_number": "253-444-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980021311",
            "telephone_number": "253-444-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHNO",
        "first_name": "KHAMPHO",
        "middle_name": "THAMMAVONGXAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA 60250454",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GU",
            "license": "PA-84",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.