Active NPI
Tesfanesh McClelland
- Physician Assistant
- Bremerton, WA
National Provider Identifier
1225997489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1225997489
- Practice address
- 1 Boone Rd
Bremerton, WA 98312-1894 - Phone
- (360) 476-6104
- NPI assigned
- Jan 21, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1225997489 | Primary |
Addresses
Primary practice location
1 Boone Rd
Bremerton, WA 98312-1894
Mailing address
4526 Bay Vista Blvd Apt C306
Bremerton, WA 98312-4673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773360000000",
"number": "1225997489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 BAY VISTA BLVD APT C306",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983124673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BOONE RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121894",
"telephone_number": "360-476-6104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAND",
"first_name": "TESFANESH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-21",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1225997489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.