Individual provider Active NPI

Sandra Relyea, PA-C

  • Physician Assistant
  • Port Angeles, WA
National Provider Identifier
1962413633
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA608165855 Issued in WA
Practice address
433 E 8TH St
Port Angeles, WA 98362-6219
Phone
(360) 565-0999
Fax
(360) 565-7635
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12880 CA
Physician Assistant 363A00000X PA608165855 WA Primary

Addresses

Primary practice location

433 E 8TH St
Port Angeles, WA 98362-6219

Mailing address

433 E 8TH St
Port Angeles, WA 98362-6219
Phone (360) 565-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12880CAMDSpeech-Language Pathologist
PA12880CAMDPhysician Assistant
PA608165855WAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: srelyea923498@wm.providencedirect.org

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1962413633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626219",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626219",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELYEA",
        "first_name": "SANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12880",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA608165855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.