Josephine A Wachana, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60053259 Issued in WA

Practice address

505 NE 87TH Avenue
Suite 200
Vancouver, WA 98664

Phone

(360) 256-8836

Fax

(360) 256-5024

NPI assigned

Nov 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, 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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1063990695
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1194979690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9023 SE ASH",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-408-4403",
            "fax_number": "360-256-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVENUE",
            "address_2": "SUITE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "360-256-8836",
            "fax_number": "360-256-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHANA",
        "first_name": "JOSEPHINE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01272",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60053259",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60053259",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "7736883",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "505 NE 87th Avenue",
            "address_2": "Suite 200",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Vu, DMD
• Jennifer Vulgan
• Miator Vululleh
• Tam Tri Vuong, M.D.
• Vvi Transportation LLC
• Daniel Edwin Wachenheim, MD
• Paul Daniel Waddington
• Sally Marie Waddle, PA-C
• Andrew Wade, DC
• Nicole Kathleen Wade, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.