NPIMap

Individual provider Active NPI

Alisha Ashurst Wallace, PA-C

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1487627345
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61642884 Issued in WA
Practice address
12303 NE 130TH LN Ste 450
Kirkland, WA 98034-3032
Phone
(425) 899-6400
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61642884 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN Ste 450
Kirkland, WA 98034-3032

Mailing address

12303 NE 130TH LN Ste 450
Kirkland, WA 98034-3032
Phone (425) 899-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060103000630 HI Practitioner - Physician Assistant 5496777526 Reassigns benefits to 1 organization
I20251010001616 WA Practitioner - Physician Assistant 5496777526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castle Medical CenterGroup PAC ID 6608762778, 77 clinicians

Practice addresses (Care Compare)

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

12303 NE 130TH LN
Suite 420
Kirkland, WA 98034-3042
Phone (425) 899-6400

640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5142

642 Ulukahiki St
Kailua, HI 96734-4439

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84 of 100Reported as group
Quality
84.73
Promoting interoperability
89
Improvement activities
40
Cost
71.09

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Aug 1, 2025 Accepting new patients
Castle Medical Center CurrentSince May 10, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Castle Medical Center CurrentSince May 10, 2022 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Aug 1, 2025 Accepting new patients

Locations

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

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

12303 NE 130th Ln
Ste 450
Kirkland, WA 98034
Phone (425) 899-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487627345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN STE 450",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343032",
            "telephone_number": "425-899-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN STE 450",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343032",
            "telephone_number": "425-899-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALISHA",
        "middle_name": "ASHURST",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-07-13",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61642884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.