NPIMap

Individual provider Active NPI

Jacob Stephen Davison, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1871074054
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3016 E 57TH Ave Ste 27
Spokane, WA 99223-7036
Phone
(509) 342-3300
Fax
(509) 342-3331
NPI assigned
Aug 24, 2018
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OR Primary

Addresses

Primary practice location

3016 E 57TH Ave Ste 27
Spokane, WA 99223-7036

Mailing address

3016 E 57TH Ave Ste 27
Spokane, WA 99223-7036
Phone (509) 342-3300

Other practice location 1

2011 4th St
LA Grande, OR 97850-2511
Phone (541) 963-4139

Other practice location 2

505 S 336th St Ste 600
Federal Way, WA 98003-5947
Phone (209) 962-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116001614 WA Practitioner - Physician Assistant 1850636309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

300 E 5TH Ave
Spokane, WA 99202-1334

3016 E 57TH Ave
Spokane, WA 99223-7036

311 S L St
Tacoma, WA 98405-3720

400 E 5TH Ave
Spokane, WA 99202-1334
Phone (509) 838-2531

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physician Assistant CurrentSince Oct 26, 2020 Accepting new patients
Multicare Health System CurrentSince Oct 26, 2020 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

3016 E 57th Ave
Ste 27
Spokane, WA 99223
Phone (509) 342-3300

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: jdavison504840@direct.multicare.org
  • Direct secure messaging: ms_jdaviso8@landmarkhealth-direct.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1871074054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 E 57TH AVE STE 27",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237036",
            "telephone_number": "509-342-3300",
            "fax_number": "509-342-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 E 57TH AVE STE 27",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237036",
            "telephone_number": "509-342-3300",
            "fax_number": "509-342-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2011 4th St",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978502511",
            "country_code": "US",
            "telephone_number": "541-963-4139",
            "fax_number": "541-429-6612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 S 336th St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980035947",
            "country_code": "US",
            "telephone_number": "209-962-3535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JACOB",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-24",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.