Magdalena Natalia Stasiak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60298929 Issued in WA

Practice address

3240 NE 3Rd Ave
Camas, WA 98607-2408

Phone

(360) 838-2440

Fax

(360) 838-2450

NPI assigned

Oct 10, 2011

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Moses Lake Community Health Center

  • Student Health Clinic/Center
  • Quincy, WA
  • NPI 1730756644
  NPD (past)

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1275817207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-838-2440",
            "fax_number": "360-838-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-838-2440",
            "fax_number": "360-838-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASIAK",
        "first_name": "MAGDALENA",
        "middle_name": "NATALIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004164",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "AP60298929",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60298929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023084",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "33308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "80077375",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062597",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "103788",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10019630",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seok Ju Song I
• Kolby Marie Spicer, RDH
• Sydney Noel Spring, PA
• Daniel Adrian Spyker, PHD, MD
• Daniel William Starr, PT, DPT, CMT
• Amanda Lee Steele
• Steven T. Elkhal, DMD, PS
• Jedadiah L Stewart, LMP
• Angela Strawn
• Benjamin Stumpf, D.O.

• Physician Assistant in Camas, WA
• Providers in Camas, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.