Active NPI
Nancy E. Douglas, PA
- Physician Assistant
- Edmonds, WA
National Provider Identifier
1790857274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10002305
- Practice address
- 21601 76TH Ave W
Edmonds, WA 98026-7507 - Phone
- (425) 640-4100
- NPI assigned
- Nov 14, 2006
- 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 | PA10002305 | WA | Primary |
Addresses
Primary practice location
21601 76TH Ave W
Edmonds, WA 98026-7507
Mailing address
1420 E. Pine St.
301
Seattle, WA 98122
Phone (206) 328-6664
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8343147 | Medicaid | WA | |
| 5286DO | Other | REGENCE BLUE SHIELD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edmonds Emergency Physicians, Inc. | Past | Accepting new patients | |
| Cep America LLC | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 2
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
- Edmonds, WA
- NPI 1336181676
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1790857274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 E. PINE ST.",
"address_2": "301",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98122",
"telephone_number": "206-328-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21601 76TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267507",
"telephone_number": "425-640-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "NANCY",
"middle_name": "E.",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10002305",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8343147",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "5286DO",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.