Allan J. Ellsworth, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004406 Issued in WA

Practice address

1959 NE Pacific St
Seattle, WA 98195-0001

Phone

(206) 598-5618

Fax

(206) 598-5720

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Snohomish County

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD
• Public Hospital District No 1 of Snohomish County

  dba Valley General Hospital

  • Clinical Medical Laboratory
  • Sultan, WA
  • NPI 1245497577
  NPD (past)
• Sky Valley Family Medicine, PS

  • Family Medicine Physician
  • Sultan, WA
  • NPI 1093832057
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1649291196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24366",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240366",
            "telephone_number": "206-598-0502",
            "fax_number": "206-598-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-598-5618",
            "fax_number": "206-598-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "ALLAN",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8356339",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0170439",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "55843U",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanette Ellison, ARNP
• Katherine Dora Ellison, DC
• Michelle Elliston, RDN
• Seth Jon Ellner, MSW
• Kathleen E Ellsbury
• Amy L Ellsworth, PAC
• Hannah Elizabeth Ellsworth, ARNP
• Alaa Adel Elmaoued, MD
• Sara Elmarakshy, R.PH.
• Sahra Elmi

• Medical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.