Lisa D Zylstra, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004703 Issued in WA

Practice address

406 SE 131St Ave Ste C305
Vancouver, WA 98683-4004

Phone

(360) 816-0277

Fax

(360) 567-4004

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa M Dekker Former name

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

State licenses

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.

• L Katherine Moon

  • Family Medicine Physician
  • Vancouver, WA
  • NPI 1275295164
  Medicare reassignment

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1821142738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24015 NE W H GARNER RD",
            "city": "YACOLT",
            "state": "WA",
            "postal_code": "986754303",
            "telephone_number": "360-823-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE C305",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-816-0277",
            "fax_number": "360-567-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLSTRA",
        "first_name": "LISA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DEKKER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Elaine Zupfer, PA-C
• Jonathan Edward Zwart, MD
• Suzanna Zweifel, LMP
• Mary Kathryn Zweig
• Jonah I Zwemer, MD

• Medical Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.