Individual provider Active NPI

Alisha Fong, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1508484981
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61593428 Issued in WA
Practice address
1629 N 45TH St
Seattle, WA 98103-6701
Phone
(206) 548-2964
NPI assigned
Jul 11, 2020
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA61593428 WA Primary

Addresses

Primary practice location

1629 N 45TH St
Seattle, WA 98103-6701

Mailing address

1200 12TH Ave S Ste 901
Seattle, WA 98144-2712
Phone (206) 548-3114

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
I20250205002757 WA Practitioner - Physician Assistant 0244760213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborcare HealthGroup PAC ID 0143134205, 100 clinicians

Practice addresses (Care Compare)

1629 N 45TH St
Seattle, WA 98103-6701
Phone (206) 633-3350

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Mar 10, 2025 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Mar 10, 2025 Accepting new patients
Neighborcare Health Past Accepting new patients

Locations

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1594425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1508484981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-548-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036701",
            "telephone_number": "206-548-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "ALISHA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-11",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61593428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.