NPIMap

Individual provider Active NPI

Krystle Cabales Agtarap, PA

  • Surgical Physician Assistant
  • Olympia, WA
National Provider Identifier
1972907590
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60536710 Issued in WA
Practice address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone
(360) 923-7000
Fax
(360) 923-7089
NPI assigned
Oct 9, 2014
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 PA60536710 WA Primary

Addresses

Primary practice location

700 Lilly Rd NE
Olympia, WA 98506-5115

Mailing address

1944 Lighthouse LN NE
Tacoma, WA 98422-3473
Phone (253) 318-1490

Other practice location 1

401 W Slaughter Ln Ste 300
Austin, TX 78748-1774
Phone (512) 888-1201

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709003029 WA Practitioner - Physician Assistant 1052623600 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

615 Lilly Rd NE
Olympia, WA 98506-5117
Phone (360) 491-4211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60536710WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Orthopaedic Associates PLLC CurrentSince Dec 1, 2024 Accepting new patients
Olympia Orthopaedic Associates, PLLC CurrentSince Dec 1, 2024 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Apr 27, 2015 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 6, 2023 Accepting new patients
Multicare Health System CurrentSince Nov 14, 2016 Accepting new patients
Multicare Health System CurrentSince Nov 14, 2016 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Apr 27, 2015 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 6, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

1330 Rockefeller Ave
Ste 450
Everett, WA 98201
Phone (206) 258-6801

1728 W Marine View Dr
Ste 111
Everett, WA 98201

3726 Broadway
Ste 201
Everett, WA 98201
Phone (425) 317-9119

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3901 Capital Mall Dr SW
#A
Olympia, WA 98502
Phone (360) 570-3460

615 Lilly Rd NE
Ste 240
Olympia, WA 98506
Phone (360) 413-3850

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

3124 S 19th St
Ste 340
Tacoma, WA 98405
Phone (253) 459-7000

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

316 S K St
Tacoma, WA 98405
Phone (253) 403-1375

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kagtarap4262874@ghc.direct-ci.net
  • Direct secure messaging: krystle.agtarap.1@5512.direct.athenahealth.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1972907590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 LIGHTHOUSE LN NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984223473",
            "telephone_number": "253-318-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000",
            "fax_number": "360-923-7089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 W Slaughter Ln Ste 300",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787481774",
            "country_code": "US",
            "telephone_number": "512-888-1201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGTARAP",
        "first_name": "KRYSTLE",
        "middle_name": "CABALES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60536710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.