Individual provider Active NPI

Spencer Patrick Fayles, PA-S

  • Medical Physician Assistant
  • Puyallup, WA
National Provider Identifier
1679459978
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in WA
Practice address
4505 S Meridian Ste a
Puyallup, WA 98373-5002
Phone
(253) 697-5780
Fax
(253) 864-2972
NPI assigned
Aug 12, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING WA Primary

Addresses

Primary practice location

4505 S Meridian Ste a
Puyallup, WA 98373-5002

Mailing address

608 39TH Ave SW Apt J302
Puyallup, WA 98373-3660
Phone (801) 706-8335

Other practice location 1

5700 100th St SW Ste 500
Lakewood, WA 98499-2763
Phone (253) 459-6005

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
I20251118003738 WA Practitioner - Physician Assistant 9537650478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

608 39TH Ave SW Apt
J302
Puyallup, WA 98373-3660

PO Box
Suite 5299
Tacoma, WA 98415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGWAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 31, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 31, 2025 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1679459978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 39TH AVE SW APT J302",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733660",
            "telephone_number": "801-706-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 S MERIDIAN STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735002",
            "telephone_number": "253-697-5780",
            "fax_number": "253-864-2972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 100th St SW Ste 500",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992763",
            "country_code": "US",
            "telephone_number": "253-459-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAYLES",
        "first_name": "SPENCER",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.