Individual provider Active NPI

Jordan Machen, PA-C

  • Physician Assistant
  • Puyallup, WA
National Provider Identifier
1568935476
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60902500 Issued in WA
Practice address
1007 39TH Ave SE
Puyallup, WA 98374-2192
Phone
(253) 435-3100
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 9771658 ID
Physician Assistant 363A00000X 60902500 WA Primary

Addresses

Primary practice location

1007 39TH Ave SE
Puyallup, WA 98374-2192

Mailing address

1007 39TH Ave SE
Puyallup, WA 98374-2192
Phone (253) 445-7100

Other practice location 1

700 W Ironwood Dr Ste 120
Coeur D Alene, ID 83814-4405
Phone (208) 625-3640

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20190329002394 WA Practitioner - Physician Assistant 1254672256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Midwestern University, Chicago College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

15870 1St Ave S
Suite 101
Burien, WA 98148-1301
Phone (206) 242-2501

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

5058 Main St
Suite 100
Tacoma, WA 98407-3148
Phone (253) 533-6770

7096 Lakeland Hills Way SE
Suite 103
Auburn, WA 98092-8438
Phone (253) 545-3650

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9771658IDMDPhysician Assistant
60902500WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 15, 2019 Accepting new patients
Multicare Health System CurrentSince Aug 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 15, 2019 Accepting new patients
Multicare Health System Physician Assistant CurrentSince Aug 1, 2025 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients
Kootenai Health, Inc. Physician Assistant Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

1007 39th Ave SE
Puyallup, WA 98374
Phone (253) 435-3100

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 8

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 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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1568935476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 39TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742192",
            "telephone_number": "253-445-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 39TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742192",
            "telephone_number": "253-435-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Ironwood Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144405",
            "country_code": "US",
            "telephone_number": "208-625-3640",
            "fax_number": "208-625-3645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACHEN",
        "first_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9771658",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60902500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1007 39th Ave SE",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983742192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.