Fortunato Placencia Jr.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6808 220TH St SW Ste 201
Mountlake Terrace, WA 98043-2187

Phone

(425) 640-6976

NPI assigned

Aug 29, 2025

Last updated

Aug 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

University of Washington School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sound Pain AllianceGroup PAC ID 0941565162, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Sound Pain Alliance

  dba Black Stone Health

  • Pain Medicine Physician
  • Bellingham, WA
  • NPI 1649776394
  Medicare reassignment Care Compare group NPD
• Sound Pain Alliance

  dba Mt. Baker Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
  • NPI 1457695116
  NPD
• Sound Pain Alliance

  dba Black Stone Health

  • Pain Clinic/Center
  • Corvallis, OR
  • NPI 1437893286
  NPD
• Sound Pain Alliance

  dba Mt Baker Pain Clinic

  • Pain Clinic/Center
  • Burlington, WA
  • NPI 1538405709
  NPD (past)

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1790664068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 MISSION AVE",
            "city": "CASHMERE",
            "state": "WA",
            "postal_code": "988151052",
            "telephone_number": "509-881-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 201",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "425-640-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACENCIA",
        "first_name": "FORTUNATO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nhat Pham, DDS
• Kevin R Piasecki, MSPT, OCS
• Mary Rose Toledo Picardal, MSW, LICSW
• Andrea Pierce
• Pinpoint Behavioral Services
• Shalea Ray Plasky
• Marsha Poischbeg
• Amy Melissa Porter, ARNP
• Devin Porter, DPT
• Lisa Marie Post, LPCC

• Physician Assistant in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.