Individual provider Active NPI

Selby J Parker, PAC

  • Physician Assistant
  • Port Angeles, WA
National Provider Identifier
1215906334
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003470 Issued in WA
Practice address
939 Caroline St
Port Angeles, WA 98362-3909
Phone
(360) 417-7381
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PA10003470 WA Primary

Addresses

Primary practice location

939 Caroline St
Port Angeles, WA 98362-3909

Mailing address

939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 417-7381

Other identifiers 2

IdentifierTypeStateIssuer
8128357MedicaidWA
1709PAOtherREGENCE BLUE SHIELD RIDER

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
I20090914000156 WA Practitioner - Physician Assistant 2860548088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fandm Healthcare, LLCGroup PAC ID 8628462983, 30 clinicians

Practice addresses (Care Compare)

Tacoma, WA 98406
Phone (253) 777-1423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003470WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Emergency Physicians Services Inc PS Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215906334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623909",
            "telephone_number": "360-417-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623909",
            "telephone_number": "360-417-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SELBY",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8128357",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD RIDER",
            "identifier": "1709PA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.