Individual provider Active NPI

Mia Gilson, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1851743561
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61129329 Issued in WA
Practice address
200 NE Mother Joseph PL Ste 330
Vancouver, WA 98664-3288
Phone
(360) 514-2990
Fax
(360) 514-3508
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3392 TN
Physician Assistant 363A00000X PA61129329 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 330
Vancouver, WA 98664-3288

Mailing address

979 E 3Rd St Ste C735
Chattanooga, TN 37403-3310
Phone (423) 778-9101

Other practice location 1

979 E 3rd St Ste C735
Chattanooga, TN 37403-3310
Phone (423) 778-9101

Other names 1

  • Mia Malin Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210407001621 WA Practitioner - Physician Assistant 5294015699 Reassigns benefits to 1 organization
I20240918003585 OR Practitioner - Physician Assistant 5294015699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

505 NE 87TH Ave
Vancouver, WA 98664-1965

8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Apr 12, 2021 Accepting new patients
University Professional Services CurrentSince Oct 1, 2024 Accepting new patients
University Professional Services CurrentSince Oct 1, 2024 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

200 NE Mother Joseph Pl
Ste 330
Vancouver, WA 98664
Phone (360) 514-2990

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990

Interoperability endpoints

  • Direct secure messaging: mgilson181511@direct.ohsu.edu
  • Direct secure messaging: mmalin472387@direct.peacehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1851743561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE C735",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033310",
            "telephone_number": "423-778-9101",
            "fax_number": "423-778-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 330",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643288",
            "telephone_number": "360-514-2990",
            "fax_number": "360-514-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "979 E 3rd St Ste C735",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374033310",
            "country_code": "US",
            "telephone_number": "423-778-9101",
            "fax_number": "423-778-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILSON",
        "first_name": "MIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3392",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61129329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "MALIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.