Medina Othman Glenn, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA70040194 Issued in WA

Practice address

1701 N 13TH St
Shelton, WA 98584-2077

Phone

(360) 426-2653

NPI assigned

Oct 24, 2025

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

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

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Public Hospital District No 1 of Mason County

  dba Mason Health-Mason General Hospital

  • Critical Access Hospital
  • Shelton, WA
  • NPI 1760568752
  Medicare reassignment
• Public Hospital District No 1 of Mason County Wa

  dba Mason General Hospital Mountain View Women's Health

  • Clinic/Center
  • Shelton, WA
  • NPI 1316174774
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Public Hospital District No 1 of Mason County

  dba Mason General Hospital Family Health

  • Clinic/Center
  • Shelton, WA
  • NPI 1700111986

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County

  dba Mason Health-Mason General Hospital

  • Critical Access Hospital
  • Shelton, WA
  • NPI 1760568752
  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  dba Mason General Hospital Ankle Foot

  • Foot & Ankle Surgery Podiatrist
  • Shelton, WA
  • NPI 1437486248

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  dba Mason General Hospital Surgery Clinic

  • Surgery Physician
  • Shelton, WA
  • NPI 1639339666

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  dba Mason County Eye Clinic

  • Ophthalmologic Surgery Clinic/Center
  • Shelton, WA
  • NPI 1922196609

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1841168507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985845001",
            "telephone_number": "360-426-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN GLENN",
        "first_name": "MEDINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-24",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA70040194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olympic Physicians P.L.L.C.
• Olympic Physicians, PLLC
• Olympic Surgical Services, P.L.L.C.
• Optical Shop of Wa Inc
• Lora Osborne
• Jack Lynn Ott, RPH
• Jared Preston Outen
• Joel Owens
• Deanna Paige
• Shannon L Paine, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.