Evening Rose Glaser, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005209 Issued in WA

Practice address

406 SE 131St Ave Ste 104
Vancouver, WA 98683-4031

Phone

(877) 522-1275

Fax

(833) 888-7145

NPI assigned

Oct 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR, ID3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ideal Option PLLCGroup PAC ID 6709013105, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations (25 of 48)

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.

• Ideal Option, PLLC

  • Clinic/Center
  • Kennewick, WA
  • NPI 1457788275

  ID, OR

  Medicare reassignment Care Compare group NPD
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Renton, WA
  • NPI 1346754868

  ID, OR

  Medicare reassignment
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Kennewick, WA
  • NPI 1841648623
  NPD
• Advanced Gastroenterology

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1962706655
  NPD (past)
• Ideal Option, PLLC

  • Clinic/Center
  • Newport, OR
  • NPI 1366320327
  NPD (past)
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Rosedale, MD
  • NPI 1427561828
  NPD (past)

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1932398260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 NE 18TH ST APT 526",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845108",
            "telephone_number": "360-828-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834031",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "EVENING",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9103137",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina A Gjesvold, LICSW
• Shannon Glade
• Savannah Glahn, RN
• Glamour Adult Family Home
• Michael J Glanzer, OD
• Graham D Glass, MD
• Krista Lorraine Glasson Killmer, PHARM.D.
• Haley Glassy
• Samara Alexis Glavin, PMHNP
• Andee Gleason

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.