Sierra Butler, PA-C
Individual provider Active NPI Physician Assistant · Moses Lake, WA
NPI 1487216420 · NPPES record last updated Jun 3, 2021
Key facts
- NPI
- 1487216420
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA60971025 (WA)
- Practice address
- 605 S Coolidge St
Moses Lake, WA 98837-1893 - Phone
- (509) 765-0674
- Fax
- (509) 764-0344
- NPI assigned
- Jun 29, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Moses Lake Community Health Center
Practice addresses (Care Compare)
1450 1St Ave SW
Quincy, WA 98848-1695
Phone (509) 787-6423
605 S Coolidge St
Suite 101
Moses Lake, WA 98837-1893
Phone (509) 765-0674
Hospital & facility affiliations
- Quincy Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200129001960 | WA | Practitioner - Physician Assistant | 6002242781 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60971025 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moses Lake Community Health Center | Current |
Accepting new patients | |
| Moses Lake Community Health Center | Current |
Accepting new patients | |
| Moses Lake Community Health Center | Past | Accepting new patients |
Locations
605 S Coolidge St
Moses Lake, WA 98837
Phone (509) 765-0674
605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674
1450 1st Ave SW
Quincy, WA 98848
Phone (509) 787-6423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60971025 | WA | Yes |
Addresses
Primary practice location
605 S Coolidge St
Moses Lake, WA 98837-1893
Mailing address
605 S Coolidge St
Moses Lake, WA 98837-1893
Phone (509) 765-0674
Other providers in Moses Lake, WA
- Joshua Lawrence Bruce
- Randy Clair Bruce
- Philip D Buckley
- Natalie Buckman
- Danika Marie Burton
- Rebecca L Byers
- Dino A Cacchiotti
- Marissa Ann Cain
- Jay K Callarman
- Calvin L. Despain, DDS, PLLC
All providers in Moses Lake, WA · Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.