Individual provider Active NPI

Christina Davis Winkley, PA-C

  • Physician Assistant
  • Bellevue, WA
National Provider Identifier
1881035053
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60507916 Issued in WA
Practice address
1750 112TH Ave NE
Suite D 050
Bellevue, WA 98004-3752
Phone
(206) 215-3850
Fax
(206) 215-3870
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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 PA60507916 WA Primary

Addresses

Primary practice location

1750 112TH Ave NE
Suite D 050
Bellevue, WA 98004-3752

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 1

IdentifierTypeStateIssuer
336558OtherWALABOR & INDUSTRIES

Other names 1

  • Christina M Davis Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141104001989 WA Practitioner - Physician Assistant 2062634249 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60507916WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 27, 2014 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Sep 1, 2016 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Oct 27, 2014 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Sep 1, 2016 Accepting new patients

Locations

1750 112th Ave NE
Ste D050
Bellevue, WA 98004
Phone (425) 296-3837

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

1600 E Jefferson St
Ste 101
Seattle, WA 98122
Phone (206) 320-3100

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1881035053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE",
            "address_2": "SUITE D 050",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043752",
            "telephone_number": "206-215-3850",
            "fax_number": "206-215-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKLEY",
        "first_name": "CHRISTINA",
        "middle_name": "DAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60507916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "336558",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DAVIS",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.