Individual provider Active NPI

Priti A Laselle, MD

  • Pediatrics Physician
  • Spokane, WA
National Provider Identifier
1386841708
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00048197 Issued in WA
Practice address
101 W 8TH Ave
SHMC 3 North
Spokane, WA 99204-2307
Phone
(509) 474-7500
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 46714 CO
Pediatrics Physician 208000000X MD00048197 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
SHMC 3 North
Spokane, WA 99204-2307

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 474-7500

Other practice location 1

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (253) 403-1420

Other names 1

  • Priti A Patel Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address plaselle95051@wm.providencedirect.org Direct
Direct Messaging Address plaselle95051@wm.providencedirect.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070904000663 WA Practitioner - Pediatric Medicine 6204929417 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46714COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Sep 1, 2007 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Sep 1, 2007 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

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.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1386841708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "address_2": "SHMC 3 NORTH",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065133",
            "country_code": "US",
            "telephone_number": "253-403-1420",
            "fax_number": "253-403-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASELLE",
        "first_name": "PRITI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "46714",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00048197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "plaselle95051@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 W 8th Ave",
            "address_2": "SHMC 3 North",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "plaselle95051@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PRITI",
            "last_name": "PATEL",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.