Active NPI
Shu-Tsui Lan, PA
- Medical Physician Assistant
- Seattle, WA
National Provider Identifier
1770790602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA60225033
- Practice address
- 1660 S Columbian Way
Seattle, WA 98108-1532 - Phone
- (206) 466-7237
- NPI assigned
- May 17, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004270 | GA | |
| Anesthesiologist Assistant | 367H00000X | 004270 | GA | |
| Medical Physician Assistant | 363AM0700X | PA60225033 | WA | Primary |
Addresses
Primary practice location
1660 S Columbian Way
Seattle, WA 98108-1532
Mailing address
833 Lake Washington Blvd S
Seattle, WA 98144-3311
Phone (404) 317-3551
Other practice location 1
1805 Parke Plaza Cir
Suite 103
Stone Mountain, GA 30087-3498
Phone (770) 498-9355 ext. 15
Other practice location 2
1116 Summit Ave
Seattle, WA 98101-2831
Phone (206) 323-0930 ext. 1218
Other practice location 3
1660 S Columbian Way
Seattle, WA 98108-1532
Phone (206) 466-7237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406915721A | Medicaid | GA |
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
- Associate of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004270 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northlake Pediatric Associates,PC | Past | Accepting new patients | |
| Apollomd Group Services LLC | Past | Accepting new patients | |
| Northlake Anesthesia Professionals, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Mt. Pleasant, SC
- NPI 1780839365
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1982637419
-
- Pediatrics Physician
- Stone Mountain, GA
- NPI 1518174036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1770790602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 LAKE WASHINGTON BLVD S",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981443311",
"telephone_number": "404-317-3551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-466-7237"
}
],
"practiceLocations": [
{
"address_1": "1805 Parke Plaza Cir",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Stone Mountain",
"state": "GA",
"postal_code": "300873498",
"country_code": "US",
"telephone_number": "770-498-9355 x15",
"fax_number": "770-498-6294",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1116 Summit Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981012831",
"country_code": "US",
"telephone_number": "206-323-0930 x1218",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1660 S Columbian Way",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981081532",
"country_code": "US",
"telephone_number": "206-466-7237",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAN",
"first_name": "SHU-TSUI",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "004270",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "004270",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60225033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "406915721A",
"state": "GA"
}
],
"endpoints": [],
"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 May 12, 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.