Raymond Gillen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(440) 731-0311

NPI assigned

Mar 4, 2020

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1851926372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "440-731-0311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Reilly St",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283107324",
            "country_code": "US",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLEN",
        "first_name": "RAYMOND",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Ann Gill
• Simarjeet Kaur Gill, RN
• Misty Michelle Gillarducci, CARE COORDINATOR/CPC
• Brook Gillaspie
• Mekko Kamara Gillen, PA-C
• Linda Joann Gillespie-Gateley, MSW
• Darnell Gilliam
• Sylvia Ann Gilliam, LPN
• James Gilligan, LCSW
• Jenifer T. Gillis, PA-C

• Medical Physician Assistant in Tacoma, WA
• Providers in Tacoma, 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 Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.