Maria Lynn Detherage, MS, RPAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60866304 Issued in WA

Practice address

31675 Pacific Hwy S
Federal Way, WA 98003-5407

Phone

(253) 215-1093

Fax

(253) 215-1094

NPI assigned

Aug 3, 2009

Last updated

Nov 12, 2020By the provider in NPPES

Sex

Female

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 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdetherage572340@fhsce.catholichealth.net

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.

• Franciscan Medical Group

  dba Franciscan Orthopedics-Silverdale

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment Care Compare group
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421
  NPD
• Franciscan Medical Group

  dba FMG-Lakes Anesthesia

  • Anesthesiology Physician
  • Tacoma, WA
  • NPI 1831358282
  NPD
• Franciscan Medical Group

  dba Franciscan Medical Clinic-Gig Harbor

  • Family Medicine Physician
  • Gig Harbor, WA
  • NPI 1386602555

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Washington

  dba St Joseph Lab PAC LAB

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1659585370

  Hospital

  Care Compare affiliation
• Commonspirit Washington

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  Care Compare affiliation
• Franciscan Health System

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1124291117
  Care Compare affiliation

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1720219173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31675 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035407",
            "telephone_number": "253-215-1093",
            "fax_number": "253-215-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31675 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035407",
            "telephone_number": "253-215-1093",
            "fax_number": "253-215-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHERAGE",
        "first_name": "MARIA",
        "middle_name": "LYNN",
        "credential": "MS, RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60866304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211807",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdetherage572340@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "31675 Pacific Hwy S",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980035407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dependable Staffing Agency
• Christopher Depretis, PT
• Audrey Hwa Desilet, ARNP
• Margaret Jocelyne Despres, CCC-SLP
• Claire Olivia Deters, DC
• Gaston R Deysine, MD
• Tarneet Dhaliwal, OD
• Thasan Singh Dhaliwal
• Sharnjit Kaur Dhesi, DC
• Gurvinder Dhillon, FNP

• Physician Assistant in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.