Amanda R Stalder

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61125398 Issued in WA

Practice address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Phone

(206) 616-4001

NPI assigned

Jan 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: astalder320858@direct.multicare.org

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1770823791
  Medicare reassignment
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Community/Behavioral Health Agency
  • Auburn, WA
  • NPI 1861872178
  NPD
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1073854766
  NPD

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1801435284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALDER",
        "first_name": "AMANDA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61125398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler J. Stahl, MA
• Michelle Staiger, PHARMD
• Patrice Staiger, ARNP
• Thomas O Staiger
• Sherri Jean Stair, OTR
• Abigail Staley
• Elizabeth M Staley, M.D., PH.D.
• Helen Zhen Stalker
• Jennifer Stallings, R.D.
• Kathryn R Stallman, LICSW

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.