Individual provider Active NPI

Gian Justin G. Kho, PA-C

  • Surgical Physician Assistant
  • Renton, WA
National Provider Identifier
1336020064
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61617680 Issued in WA
Practice address
4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone
(425) 656-5060
Fax
(425) 656-5047
NPI assigned
Sep 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61617680 WA Primary

Addresses

Primary practice location

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791

Mailing address

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone (425) 656-5060

Other practice location 1

1620 Lake Tapps Pkwy SE Ste 115
Auburn, WA 98092-8376
Phone (253) 246-2860

Other practice location 2

27005 168th Pl SE Ste 201
Covington, WA 98042-4902
Phone (253) 630-3660

Other practice location 3

24060 SE Kent Kangley Rd Ste D-100
Maple Valley, WA 98038-6851
Phone (425) 358-7708

Other practice location 4

3600 Lind Ave SW Ste 170
Renton, WA 98057-4934
Phone (425) 656-5060

Other practice location 5

150 Andover Park W
Tukwila, WA 98188-2801
Phone (425) 979-2663

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260129000886 WA Practitioner - Physician Assistant 2466930714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

27005 168TH PL SE
Suite 201
Covington, WA 98042-4902
Phone (253) 630-3660

4011 Talbot Rd S
Suite 300
Renton, WA 98055-5791
Phone (206) 656-5060

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61617680WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Physician Assistant CurrentSince Jan 5, 2026 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Jan 5, 2026 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

1620 Lake Tapps Pkwy SE
Ste 115
Auburn, WA 98092
Phone (253) 246-2860

27005 168th Pl SE
#201
Covington, WA 98042
Phone (253) 630-3660

24060 SE Kent Kangley Rd
#D100
Maple Valley, WA 98038
Phone (425) 358-7708

3600 Lind Ave SW
Ste 170
Renton, WA 98057
Phone (425) 656-4260

4011 Talbot Rd S
Ste 300
Renton, WA 98055
Phone (206) 656-5060

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

150 Andover Park W
Tukwila, WA 98188
Phone (425) 979-2663

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1336020064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Lake Tapps Pkwy SE Ste 115",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980928376",
            "country_code": "US",
            "telephone_number": "253-246-2860",
            "fax_number": "253-246-2861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27005 168th Pl SE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "WA",
            "postal_code": "980424902",
            "country_code": "US",
            "telephone_number": "253-630-3660",
            "fax_number": "253-631-1591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24060 SE Kent Kangley Rd Ste D-100",
            "address_purpose": "LOCATION",
            "city": "Maple Valley",
            "state": "WA",
            "postal_code": "980386851",
            "country_code": "US",
            "telephone_number": "425-358-7708",
            "fax_number": "425-656-5047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Lind Ave SW Ste 170",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980574934",
            "country_code": "US",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Andover Park W",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882801",
            "country_code": "US",
            "telephone_number": "425-979-2663",
            "fax_number": "425-524-4447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHO",
        "first_name": "GIAN JUSTIN",
        "middle_name": "G.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-09",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61617680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.