Individual provider Active NPI

Timothy Salvos, PA

  • Physician Assistant
  • College Place, WA
National Provider Identifier
1467972646
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60785165 Issued in WA
Practice address
1705 SE Meadowbrook Blvd Ste 2
College Place, WA 99324-1756
Phone
(888) 227-3312
Fax
(509) 529-2858
NPI assigned
Jun 20, 2017
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 PA60785165 WA Primary

Addresses

Primary practice location

1705 SE Meadowbrook Blvd Ste 2
College Place, WA 99324-1756

Mailing address

PO Box 2928
Portland, OR 97208-2928
Phone (425) 207-5155

Other practice location 1

6710 W Okanogan Pl
Kennewick, WA 99336-8001
Phone (509) 942-2528

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
I20170829000117 WA Practitioner - Physician Assistant 7113290024 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care and Medical Centers PSGroup PAC ID 7618865775, 19 clinicians

Practice addresses (Care Compare)

1215 George Washington Way
Richland, WA 99352-3411
Phone (509) 946-1695

1516 Jadwin Ave
Richland, WA 99354-2902
Phone (509) 946-1695

3601 Plaza Way
Kennewick, WA 99338-2716
Phone (509) 236-0391

4001 Tieton Dr
Yakima, WA 98908-3345
Phone (509) 410-0746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60785165WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas Valley Urgent Care PLLC CurrentSince Oct 3, 2024 Accepting new patients
Thuthi Enterprises, LLC CurrentSince Apr 1, 2024 Accepting new patients
Northwest Healthcare and Wellness Center, PLLC Past Accepting new patients

Locations

702 E Mountain View Ave
#1
Ellensburg, WA 98926
Phone (509) 968-5273

715 North Park Ctr
Ste B
Selah, WA 98942
Phone (509) 426-2378

Interoperability endpoints

  • Direct secure messaging: tsalvos287227@direct.lhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1467972646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2928",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082928",
            "telephone_number": "425-207-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 SE MEADOWBROOK BLVD STE 2",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241756",
            "telephone_number": "888-227-3312",
            "fax_number": "509-529-2858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6710 W Okanogan Pl",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993368001",
            "country_code": "US",
            "telephone_number": "509-942-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALVOS",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60785165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Place, WA

Sources for this page

Verify at the official NPI Registry.