NPIMap

Individual provider Active NPI

Brianne Patricia Randall-Gay, PA-C

  • Physician Assistant
  • Issaquah, WA
National Provider Identifier
1306270137
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60509009 Issued in WA
Practice address
751 NE Blakely Dr Ste 2030
Issaquah, WA 98029-6201
Phone
(425) 313-7080
Fax
(425) 313-7074
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 PA60509009 WA Primary

Addresses

Primary practice location

751 NE Blakely Dr Ste 2030
Issaquah, WA 98029-6201

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
1306270137MedicaidWA

Other names 1

  • Miss Brianne Patricia Randall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150226001511 WA Practitioner - Physician Assistant 9739316548 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60509009WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Nov 15, 2019 Accepting new patients
Swedish Health Services CurrentSince Oct 31, 2016 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Nov 15, 2019 Accepting new patients
Sea Mar Community Health Centers Physician Assistant CurrentSince Nov 22, 2014 Accepting new patients
Sea Mar Community Health Centers CurrentSince Nov 22, 2014 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Organizations & group practices 10

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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1306270137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR STE 2030",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-7080",
            "fax_number": "425-313-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL-GAY",
        "first_name": "BRIANNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60509009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306270137",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNE",
            "last_name": "RANDALL",
            "middle_name": "PATRICIA",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.