Individual provider Active NPI

Jeffery Fernandez, PAC

  • Medical Physician Assistant
  • Seattle, WA
National Provider Identifier
1922034743
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10004079 Issued in WA
Practice address
1600 E Jefferson St
Ste 400
Seattle, WA 98122-5698
Phone
(206) 323-1900
Fax
(206) 323-6868
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10004079 WA Primary

Addresses

Primary practice location

1600 E Jefferson St
Ste 400
Seattle, WA 98122-5698

Mailing address

1600 E Jefferson St Ste 400
Seattle, WA 98122-5647
Phone (206) 323-1900

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
I20081126000294 WA Practitioner - Physician Assistant 7214097815 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004079WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Spine Institute PLLC CurrentSince Jul 13, 2015 Accepting new patients
Orthopedics International LTD PS Past Accepting new patients
Orthopedics International LTD. PS Past Accepting new patients

Locations

550 16th Ave
Ste 404
Seattle, WA 98122
Phone (206) 322-1765

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1922034743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225647",
            "telephone_number": "206-323-1900",
            "fax_number": "206-323-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST",
            "address_2": "STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225698",
            "telephone_number": "206-323-1900",
            "fax_number": "206-323-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JEFFERY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.