Individual provider Active NPI

Scarlet Nordholm

  • Physician Assistant
  • Puyallup, WA
National Provider Identifier
1982597753
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA70012513 Issued in WA
Practice address
11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848
Phone
(253) 770-3700
NPI assigned
May 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA70012513 WA Primary

Addresses

Primary practice location

11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848

Mailing address

11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848

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
I20260116000693 WA Practitioner - Physician Assistant 0143707588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

11216 Sunrise Blvd E
Suite 3 207
Puyallup, WA 98374-8848
Phone (253) 770-3700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA70012513WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC CurrentSince Jan 6, 2026 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Jan 6, 2026 Accepting new patients
Washington Gastroenterology PLLC Physician Assistant PastSince Nov 9, 2025 Accepting new patients

Locations

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 3-207
Puyallup, WA 98374

11216 Sunrise Blvd E
Ste 3207
Puyallup, WA 98374
Phone (253) 770-3700

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

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.

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": "1748649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1982597753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E STE 3-207",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E STE 3-207",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848",
            "telephone_number": "253-770-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDHOLM",
        "first_name": "SCARLET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-31",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA70012513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.