Active NPI
Melissa Glick, P.A.
- Physician Assistant
- Seattle, WA
National Provider Identifier
1730178567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1131
- Practice address
- 201 16TH Ave E
Seattle, WA 98112-5226 - Phone
- (206) 326-3000
- NPI assigned
- Oct 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1131 | OK | Primary |
Addresses
Primary practice location
201 16TH Ave E
Seattle, WA 98112-5226
Mailing address
201 16TH Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000
Other practice location 1
1705 Renaissance Blvd
Suite 120
Edmond, OK 73013-3022
Phone (405) 715-4496
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1131 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1730178567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 16TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125226",
"telephone_number": "206-326-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 16TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125226",
"telephone_number": "206-326-3000"
}
],
"practiceLocations": [
{
"address_1": "1705 Renaissance Blvd",
"address_2": "SUITE 120",
"address_purpose": "LOCATION",
"city": "Edmond",
"state": "OK",
"postal_code": "730133022",
"country_code": "US",
"telephone_number": "405-715-4496",
"fax_number": "405-715-4499",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLICK",
"first_name": "MELISSA",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-14",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "1131",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "201 16th Ave E",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981125226",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.