Evelina Avetisova, AGPC-NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP61494666 Issued in WA

Practice address

15214 Aurora Ave N
Shoreline, WA 98133-6143

Phone

(888) 405-6396

Fax

(415) 252-7176

NPI assigned

Oct 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iora Health Washington Physicians PCGroup PAC ID 1355614421, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Iora Health Washington Physicians, P.C.

  • Internal Medicine Physician
  • Federal Way, WA
  • NPI 1023547072
  Medicare reassignment Care Compare group NPD
• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1710386545
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Iora Health Washington Physicians, P.C.

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1053805721
  NPD
• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1659790921
  NPD
• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Arvada, CO
  • NPI 1760867428
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1649722034
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1871848457
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1609657816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SOLOMON RD APT G302",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986261772",
            "telephone_number": "323-372-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336143",
            "telephone_number": "888-405-6396",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVETISOVA",
        "first_name": "EVELINA",
        "name_prefix": "Ms.",
        "credential": "AGPC-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "10017243",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61494666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Etsegenet Abate Assefa, PHARMD
• Tamara Zina Anne Atkins, M.D.
• Dawn L Atlas, LMP
• Aurora Oaks, LLC
• Aurora Village Physical Therapy, Inc
• Linda Ruth Ayers
• Christine N Babcock
• Annenelia Bach, LMT
• Emma Badner
• Seung Baek, DDS

• Gerontology Nurse Practitioner in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.