Individual provider Active NPI

Katherine T. King, PA-C

  • Surgical Physician Assistant
  • Everett, WA
National Provider Identifier
1386355428
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61386620 Issued in WA
Practice address
1100 Pacific Ave Ste 300
Everett, WA 98201-4261
Phone
(425) 339-2433
Fax
(425) 339-8273
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA61386620 WA Primary

Addresses

Primary practice location

1100 Pacific Ave Ste 300
Everett, WA 98201-4261

Mailing address

1100 Pacific Ave Ste 300
Everett, WA 98201-4261
Phone (425) 339-2433

Other practice location 1

19200 N Kelsey St
Monroe, WA 98272-1431
Phone (425) 339-2433

Other identifiers 1

IdentifierTypeStateIssuer
2258660MedicaidWA

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
I20231016002920 WA Practitioner - Physician Assistant 0840645545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61386620WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Surgical CurrentSince Oct 16, 2023 Accepting new patients
King County Public Hospital District No. 2 CurrentSince May 26, 2025 Accepting new patients
Proliance Surgeons, Inc., P.S. Physician Assistant CurrentSince Oct 16, 2023 Accepting new patients
King County Public Hospital District No 2 CurrentSince May 26, 2025 Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

1100 Pacific Ave
Ste 300
Everett, WA 98201
Phone (425) 337-7000

12039 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 899-4810

14841 179th Ave SE
Ste 330
Monroe, WA 98272
Phone (360) 794-3300

19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555

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

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.

Hospital & facility affiliations 1

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": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1386355428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC AVE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014261",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC AVE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014261",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19200 N Kelsey St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982721431",
            "country_code": "US",
            "telephone_number": "425-339-2433",
            "fax_number": "425-339-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KATHERINE",
        "middle_name": "T.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61386620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2258660",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.