Active NPI
Kenneth Sallas
- Physician Assistant
- Auburn, WA
National Provider Identifier
1609956895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10004745
- Practice address
- 202 N Division St
Plaza 2, Suite 302
Auburn, WA 98001-4939 - Phone
- (253) 394-0125
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10004745 | WA | Primary |
| Physician Assistant | 363A00000X | PA54732 | CA |
Addresses
Primary practice location
202 N Division St
Plaza 2, Suite 302
Auburn, WA 98001-4939
Mailing address
202 N Division St
Plaza 2, Suite 302
Auburn, WA 98001-4939
Phone (253) 394-0125
Other practice location 1
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3202
Phone (760) 340-3911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9103236 | Other | WA | WASH STATE LICENSE |
Other names 1
- Kenneth Earl Lee
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR, NY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Washington School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
180 NE 192ND Ave
Suite 505
Vancouver, WA 98684-7525
Phone (503) 305-6262
7500 NE 117TH Ave
Vancouver, WA 98662-4716
Phone (503) 305-6262
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA54732 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uptown Providers PC | Current | Accepting new patients | |
| Uptown Providers Inc | Current | Accepting new patients | |
| Uptown Providers PC | Past | Accepting new patients | |
| Eastside Foot and Ankle | Past | Accepting new patients |
Locations
14278 SW Allen Blvd
Beaverton, OR 97005
180 NE 192nd Ave
Ste 505
Vancouver, WA 98684
Interoperability endpoints
- kenneth.sallas.1@10370.direct.athenahealth.com
Organizations & group practices 11
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.
-
- Urgent Care Clinic/Center
- Vancouver, WA
- NPI 1255102034
-
- General Acute Care Hospital
- Rancho Mirage, CA
- NPI 1013981554
-
- Neurological Surgery Physician
- Gresham, OR
- NPI 1942552062
-
- Emergency Medicine Physician
- Amsterdam, NY
- NPI 1487484523
-
- Urgent Care Clinic/Center
- Tigard, OR
- NPI 1346903531
-
- Emergency Medicine Physician
- Amsterdam, NY
- NPI 1700643830
-
- Emergency Medicine Physician
- Gold Beach, OR
- NPI 1336878024
-
- Urgent Care Clinic/Center
- Vancouver, WA
- NPI 1912702465
-
- Urgent Care Clinic/Center
- Portland, OR
- NPI 1134563620
-
- Foot & Ankle Surgery Podiatrist
- Portland, OR
- NPI 1669884003
-
- General Practice Physician
- Portland, OR
- NPI 1144598293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1609956895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 N DIVISION ST",
"address_2": "PLAZA 2, SUITE 302",
"city": "AUBURN",
"state": "WA",
"postal_code": "980014939",
"telephone_number": "253-394-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 N DIVISION ST",
"address_2": "PLAZA 2, SUITE 302",
"city": "AUBURN",
"state": "WA",
"postal_code": "980014939",
"telephone_number": "253-394-0125"
}
],
"practiceLocations": [
{
"address_1": "39000 Bob Hope Dr",
"address_purpose": "LOCATION",
"city": "Rancho Mirage",
"state": "CA",
"postal_code": "922703202",
"country_code": "US",
"telephone_number": "760-340-3911",
"fax_number": "760-837-8218",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALLAS",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10004745",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA54732",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASH STATE LICENSE",
"identifier": "PA9103236",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KENNETH",
"last_name": "LEE",
"middle_name": "EARL",
"credential": "PA-C",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.