NPIMap

Individual provider Active NPI

Resa Shaner, PA-C

  • Physician Assistant
  • Shelton, WA
National Provider Identifier
1619964186
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004256 Issued in WA
Practice address
1701 N 13TH St Ste 100
Shelton, WA 98584-2077
Phone
(360) 426-2653
Fax
(360) 427-7086
NPI assigned
Sep 30, 2005
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004256 WA Primary

Addresses

Primary practice location

1701 N 13TH St Ste 100
Shelton, WA 98584-2077

Mailing address

PO Box 1668
Shelton, WA 98584-5001
Phone (360) 427-9549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 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
I20040329001802 WA Practitioner - Physician Assistant 1052203379 Reassigns benefits to 3 organizations
I20250225003130 TX Practitioner - Physician Assistant 1052203379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

2430 N 13TH St
Shelton, WA 98584-1213
Phone (360) 426-1651

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004256WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County CurrentSince May 20, 2009 Accepting new patients
Public Hospital District No 1 of Mason County Wa CurrentSince May 20, 2009 Accepting new patients
Altea Medical Washington PLLC CurrentSince Nov 20, 2025 Accepting new patients
Public Hospital District No 1 of Mason County Washington CurrentSince Jan 13, 2014 Accepting new patients
Post Acute Medical PLLC CurrentSince Nov 20, 2025 Accepting new patients
Public Hospital District No 1 of Mason County Current Accepting new patients
Emerson Dental Inc PC PastSince Apr 14, 2024 Accepting new patients
Fircrest Family Medicine, PLLC Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

303 Telegraph Rd
Bellingham, WA 98226
Phone (360) 863-6696

1701 N 13th St
Ste 100
Shelton, WA 98584
Phone (360) 426-2653

2430 N 13th St
Shelton, WA 98584
Phone (360) 426-1651

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

939 Mountain View Dr
Ste 100
Shelton, WA 98584
Phone (360) 426-2653

6025 N Assembly St
Spokane, WA 99205
Phone (509) 326-8282

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

Organizations & group practices 9

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 5

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1619964186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985845001",
            "telephone_number": "360-427-9549",
            "fax_number": "360-427-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST STE 100",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653",
            "fax_number": "360-427-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANER",
        "first_name": "RESA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.