Kelli Kristine Cole-Vadjic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005137 Issued in WA

Practice address

3301 Squalicum Pkwy
Bellingham, WA 98225-1919

Phone

(360) 788-8222

Fax

(360) 788-7759

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelli Kristine Cole Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcolevadjic15227@direct.peacehealth.org

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.

• Peacehealth

  dba PeaceHealth United General Medical Center

  • Critical Access Hospital
  • Sedro Woolley, WA
  • NPI 1144664954
  NPD
• Peacehealth

  dba PeaceHealth Medical Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Bellingham, WA
  • NPI 1265692842
  NPD
• Peacehealth

  dba Peace Island Medical Center

  • Family Medicine Physician
  • Friday Harbor, WA
  • NPI 1902232507
  NPD
• Bellingham Urology Specialists PLLC

  • Urology Physician
  • Bellingham, WA
  • NPI 1417038019
  NPD (past)
• Pacific Northwest Urology Specialists, PLLC

  dba Pacific Northwest Urology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
  • NPI 1952852873
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1891755989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE",
            "address_2": "DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839324",
            "telephone_number": "360-788-8222",
            "fax_number": "360-788-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251919",
            "telephone_number": "360-788-8222",
            "fax_number": "360-788-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE-VADJIC",
        "first_name": "KELLI",
        "middle_name": "KRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8469983",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "COLE",
            "middle_name": "KRISTINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Robson Coiner III, N.C.C.
• Christina Coiro, LMHC, SUDP
• Paige Coker, MS, RDN
• Robert William Colbert, M.D.
• Cole Vision Corporation (Sears Optical #C0514)
• Brooke Dawn Cole, LMP
• Elizabeth A Cole, LICSW
• Matthew David Cole, DPT
• Susanne B Cole, LMP
• Jonathan Craig Coleman

• Physician Assistant in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.