Mikel McMakin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61523671 Issued in WA

Practice address

21137 Sr 410 E Ste I
Bonney Lake, WA 98391-8775

Phone

(253) 862-5275

Fax

(855) 673-1403

NPI assigned

Jan 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lark DermatologyGroup PAC ID 8820423981, 5 clinicians

Practice addresses (Care Compare)

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.

• Lark Dermatology

  • Dermatology Physician
  • Bonney Lake, WA
  • NPI 1982256970
  Medicare reassignment Care Compare group
• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632

  Physician Assistant

  NPD

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1851154256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 LONGVIEW AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213614",
            "telephone_number": "206-992-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21137 SR 410 E STE I",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918775",
            "telephone_number": "253-862-5275",
            "fax_number": "855-673-1403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Meadows Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970350086",
            "country_code": "US",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "413 29th St NE Ste I",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983727154",
            "country_code": "US",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMAKIN",
        "first_name": "MIKEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61523671",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA219565",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "1218544",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA219565",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Allen McCorkle, DC
• Charis Marie McCoy, APRN FNP-BC
• Linda Kay McCoy, LMP
• Susan E McDonald, MD
• Edward Randall McLeary, DDS
• Veronica McNeal
• Errol Justin Medel, D.C.
• Lisa Craigs Medel, D.C.
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

• Physician Assistant in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.