Active NPI
Lynda Jo Storm, PA-C
- Medical Physician Assistant
- Lynnwood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10004574
- Practice address
- 19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748 - Phone
- (425) 563-1500
- Fax
- (425) 563-1374
- NPI assigned
- Jan 6, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10004574 | WA | Primary |
Addresses
Primary practice location
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Mailing address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180728 | Other | WA | L&I PROVIDER NUMBER |
| 178162 | Other | WA | L&I PROVIDER NUMBER |
| 8377517 | Medicaid | WA |
Other names 1
- Lynda Golder
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-4100
500 17TH Ave
Seattle, WA 98122-5711
Phone (206) 320-3700
Hospital & facility affiliations
- Providence Regional Medical Center Everett
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10004574 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc., P.S. | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients |
Locations
1100 Pacific Ave
Ste 300
Everett, WA 98201
Phone (425) 337-7000
601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Organizations & group practices 4
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.
-
- Diagnostic Radiology Physician
- Lynnwood, WA
- NPI 1932196607
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1558300434
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
- General Acute Care Hospital
- Everett, WA
- NPI 1700037801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540252800000",
"number": "1245218429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORM",
"first_name": "LYNDA",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2018-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10004574",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I PROVIDER NUMBER",
"identifier": "180728",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I PROVIDER NUMBER",
"identifier": "178162",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8377517",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LYNDA",
"last_name": "GOLDER",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.