Active NPI
Shae Kanakaole, PA-C
- Surgical Physician Assistant
- Lakewood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA61634578
- Practice address
- 7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000 - Phone
- (253) 582-7257
- Fax
- (253) 582-1617
- NPI assigned
- Dec 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Surgical Physician Assistant | 363AS0400X | PA61634578 | WA | Primary |
Addresses
Primary practice location
7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Mailing address
7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Phone (253) 582-7257
Other practice location 1
2727 Hollycroft St Ste 410
Gig Harbor, WA 98335-1369
Phone (253) 358-4002
Other practice location 2
1724 W Union Ave Ste 100
Tacoma, WA 98405-2099
Phone (253) 830-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2326471 | Medicaid | WA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-2400
1724 W Union Ave
Tacoma, WA 98405-2099
Phone (253) 830-5200
2727 Hollycroft St
Suite 410
Gig Harbor, WA 98335-1369
Phone (253) 582-7257
7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone (253) 582-7257
Hospital & facility affiliations
- St Clare Hospital
- St Joseph Medical Center
- St Anthony Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA61634578 | WA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Surgical | Current | Accepting new patients |
| Proliance Surgeons, Inc., P.S. | Surgical | Current | Accepting new patients |
Locations
2727 Hollycroft St
Ste 410
Gig Harbor, WA 98335
Phone (253) 358-4002
7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257
1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200
Interoperability endpoints
- shae.kanakaole.p73@direct.proliance.nextgenshare.com
- skanakaole826731@fhsce.catholichealth.net
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
- General Acute Care Hospital
- Gig Harbor, WA
- NPI 1447406699
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
- General Acute Care Hospital
- Lakewood, WA
- NPI 1689672693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748476800000",
"number": "1982110045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7308 BRIDGEPORT WAY W STE 201",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984998000",
"telephone_number": "253-582-7257",
"fax_number": "253-582-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7308 BRIDGEPORT WAY W STE 201",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984998000",
"telephone_number": "253-582-7257",
"fax_number": "253-582-1617"
}
],
"practiceLocations": [
{
"address_1": "2727 Hollycroft St Ste 410",
"address_purpose": "LOCATION",
"city": "Gig Harbor",
"state": "WA",
"postal_code": "983351369",
"country_code": "US",
"telephone_number": "253-358-4002",
"fax_number": "253-358-4015",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1724 W Union Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984052099",
"country_code": "US",
"telephone_number": "253-830-5200",
"fax_number": "253-752-1160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KANAKAOLE",
"first_name": "SHAE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-27",
"last_updated": "2025-05-29",
"certification_date": "2025-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA61634578",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2326471",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.