Individual provider Active NPI

Ghania Blessing Fadeela Bamba, PA-C

  • Surgical Physician Assistant
  • Renton, WA
National Provider Identifier
1396658878
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.PA.70175441 Issued in WA
Practice address
4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone
(425) 656-5060
NPI assigned
Sep 24, 2026
Last updated
Oct 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

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 WA
Surgical Physician Assistant 363AS0400X PA.PA.70175441 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

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

Other practice location 2

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

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

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

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
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793059200000",
    "number": "1396658878",
    "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"
        }
    ],
    "practiceLocations": [
        {
            "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": "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": "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": "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": "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": "BAMBA",
        "first_name": "GHANIA",
        "middle_name": "BLESSING FADEELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA.PA.70175441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2026; 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.