Individual provider Active NPI

Yaoji Pan

  • Specialist
  • Edmonds, WA
National Provider Identifier
1700637618
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA61438831 Issued in WA
Practice address
22727 Highway 99 Ste 205
Edmonds, WA 98026-8381
Phone
(425) 471-4083
Fax
(425) 577-6509
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA61438831 WA Primary

Addresses

Primary practice location

22727 Highway 99 Ste 205
Edmonds, WA 98026-8381

Mailing address

22727 Highway 99 Ste 205
Edmonds, WA 98026-8381
Phone (425) 471-4083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA61438831WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Accident & Injury Clinic LLC CurrentSince Mar 31, 2024 Accepting new patients
Core Accident & Injury Clinic LLC CurrentSince Mar 31, 2024 Accepting new patients

Locations

22727 Highway 99
Ste 205
Edmonds, WA 98026
Phone (425) 471-4083

Organizations & group practices 2

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1700637618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22727 HIGHWAY 99 STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268381",
            "telephone_number": "425-471-4083",
            "fax_number": "425-577-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22727 HIGHWAY 99 STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268381",
            "telephone_number": "425-471-4083",
            "fax_number": "425-577-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "YAOJI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA61438831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.