NPIMap

Organization Active NPI

Northwest Physician Associates PC

  • Physician Assistant
  • Arlington, WA
National Provider Identifier
1275567919
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
NORTHWEST PHYSICIAN ASSOCIATES PC
Practice address
330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone
(360) 435-2133
Fax
(253) 838-6418
NPI assigned
Jul 10, 2006
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Sharon Hardy
Title
Director Provider Enrollment
Phone
(925) 251-6901

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

330 S Stillaguamish Ave
Arlington, WA 98223-1642

Mailing address

PO Box 634596
Cincinnati, OH 45263-4596
Phone (800) 562-2945

Other identifiers 7

IdentifierTypeStateIssuer
7100183MedicaidWA
288344MedicaidOR
7200124MedicaidWA
7135510MedicaidWA
7136047MedicaidWA
112256800MedicaidWY
7131352MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031231000754 WA Part B Supplier - Clinic/Group Practice 4183523806 Receives reassigned benefits from 201 practitioners
Practice locations: Richland, WA; Tacoma, WA; Pasco, WA; Mount Vernon, WA; Lakewood, WA; Kennewick, WA; Federal Way, WA; Enumclaw, WA…
O20040119000365 OR Part B Supplier - Clinic/Group Practice 4183523806 Receives reassigned benefits from 15 practitioners
Practice locations: Albany, OR

National Provider Directory

National Provider Directory

Locations

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

1450 Battersby Ave
Enumclaw Regional Hospital
Enumclaw, WA 98022
Phone (360) 825-2505

Practitioners & affiliated clinicians

Practitioners 242

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 242

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1275567919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634596",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634596",
            "telephone_number": "800-562-2945",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S STILLAGUAMISH AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231642",
            "telephone_number": "360-435-2133",
            "fax_number": "253-838-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHYSICIAN ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "925-251-6901"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100183",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288344",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200124",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7135510",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7136047",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112256800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7131352",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.