Active NPI
John Tilley, PA-C
- Physician Assistant
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60652694
- Practice address
- 900 Pacific Ave
Everett, WA 98201-4168 - Phone
- (425) 339-5430
- Fax
- (425) 339-5454
- NPI assigned
- Jul 11, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA4432 | MA | |
| Physician Assistant | 363A00000X | PA60652694 | WA | Primary |
Addresses
Primary practice location
900 Pacific Ave
Everett, WA 98201-4168
Mailing address
7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414
Other practice location 1
1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jtilley679307@wm.providencedirect.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000
1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966
3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966
4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA4432 | MA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Washington | Current | Accepting new patients | |
| Providence Health & Services-Washington | Current | Accepting new patients | |
| Providence Health & Services- Washington | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Providence Health & Services-Wa | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Providence Health & Services - Washington | Past | Accepting new patients | |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
900 Pacific Ave
Everett, WA 98201
Phone (425) 258-7900
900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311
1700 13th St
Everett, WA 98201
Phone (425) 252-0895
1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330
Organizations & group practices 10
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.
-
dba PMG NW Wa
- General Practice Physician
- Everett, WA
- NPI 1124270715
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1831186766
-
- Mammography Clinic/Center
- Everett, WA
- NPI 1336390442
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
-
- Ambulatory Surgical Clinic/Center
- Arlington, WA
- NPI 1366154304
-
dba PMG NW WA Snohomish
- Family Medicine Physician
- Snohomish, WA
- NPI 1982855375
-
dba Providence Regional Medical Center Everett
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
dba Providence Surgery Center, Pacific Campus
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1588294854
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
-
dba PMG NW WA MC Walk In Clinic
- General Practice Physician
- Everett, WA
- NPI 1013169507
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Regional Medical Center Everett
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
- General Acute Care Hospital
- Everett, WA
- NPI 1700037801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1730444175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 EVERGREEN WAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982036421",
"telephone_number": "206-860-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 PACIFIC AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014168",
"telephone_number": "425-339-5430",
"fax_number": "425-339-5454"
}
],
"practiceLocations": [
{
"address_1": "1321 Colby Ave",
"address_purpose": "LOCATION",
"city": "Everett",
"state": "WA",
"postal_code": "982011665",
"country_code": "US",
"telephone_number": "425-261-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TILLEY",
"first_name": "JOHN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-11",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MA",
"license": "PA4432",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60652694",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jtilley679307@wm.providencedirect.org",
"affiliation": "N",
"address_1": "1700 13th St",
"city": "Everett",
"state": "WA",
"country_code": "US",
"postal_code": "982011689",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.