Individual provider Active NPI

Isaac A Kowals-Dym

  • Physician Assistant
  • Auburn, WA
National Provider Identifier
1639897374
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
202 N Division St
Auburn, WA 98001-4939
Phone
(253) 833-7711
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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 WA Primary

Addresses

Primary practice location

202 N Division St
Auburn, WA 98001-4939

Mailing address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Phone (206) 616-4001

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
I20231025001480 WA Practitioner - Physician Assistant 6800242959 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1639897374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-833-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALS-DYM",
        "first_name": "ISAAC",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.