Individual provider Active NPI

Stephanie Peace Rezendes, PA-C

  • Surgical Physician Assistant
  • Edmonds, WA
National Provider Identifier
1952703258
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60613322 Issued in WA
Practice address
21911 76TH Ave W Ste 211
Edmonds, WA 98026-7918
Phone
(425) 775-6651
Fax
(425) 670-6718
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60613322 WA Primary

Addresses

Primary practice location

21911 76TH Ave W Ste 211
Edmonds, WA 98026-7918

Mailing address

21911 76TH Ave W Ste 211
Edmonds, WA 98026-7918
Phone (425) 775-6651

Other practice location 1

13020 Meridian Ave S Fl 2
Everett, WA 98208-6468
Phone (425) 775-6651

Other practice location 2

515 Minor Ave Ste 140
Seattle, WA 98104-2138
Phone (425) 775-6651

Other identifiers 1

IdentifierTypeStateIssuer
2055928MedicaidWA

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
I20160321001336 WA Practitioner - Physician Assistant 0143527069 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

21911 76TH Ave W
Suite 211
Edmonds, WA 98026-7918
Phone (253) 770-9000

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince Mar 10, 2016 Accepting new patients
Optum Care Washington PLLC CurrentSince Jun 10, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Jun 10, 2025 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Feb 9, 2026 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Feb 9, 2026 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients
Proliance Surgeons, Inc., P.S Past Accepting new patients

Locations

21911 76th Ave W
Ste 211
Edmonds, WA 98026
Phone (253) 770-9000

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

13020 Meridian Ave S
#2
Everett, WA 98208

13020 Meridian Ave S
Fl 2
Everett, WA 98208
Phone (425) 357-3700

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

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

515 Minor Ave
Ste 140
Seattle, WA 98104
Phone (206) 682-6103

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

801 S Stevens St
Spokane, WA 99204
Phone (206) 621-4316

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: srezendes23150@direct.tecmc.com

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1952703258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 211",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 211",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13020 Meridian Ave S Fl 2",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982086468",
            "country_code": "US",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042138",
            "country_code": "US",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZENDES",
        "first_name": "STEPHANIE",
        "middle_name": "PEACE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60613322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2055928",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.