ROLIN ALAN PRUYN (NPI# 1073940219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073940219 |
| Entity Type | Individual |
| Full Name | ROLIN ALAN PRUYN |
| Credential | PA-C |
| Practice Address |
12303 Ne 130th Ln Suite 550 Kirkland WA 98034-3099 |
| Practice Telephone | 4258996972 |
| Practice Fax Number | 4258996970 |
| Mailing Telephone | 4258996972 |
| Mailing Fax Number | 4258996970 |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2016-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60435739 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12303 NE 130TH LN SUITE 550 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-3099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436687 | Shannon Lee Bailey | Obstetrics & Gynecology | 12303 Ne 130th Ln, Suite 450, Kirkland, WA 98034-3099 | 2005-06-13 |
| 1598238966 | Transform Weight Loss LLC | Surgery | 12303 Ne 130th Ln, Kirkland, WA 98034-3099 | 2019-01-08 |
| 1720551195 | Peter S. Billing Md LLC | Surgery | 12303 Ne 130th Ln, Kirkland, WA 98034-3099 | 2019-01-08 |
| 1043695190 | Amy Bartnikowski | Advanced Practice Midwife | 12303 Ne 130th Ln, Kirkland, WA 98034-3099 | 2015-07-29 |
| 1003290073 | Xuemei Su | Nurse Practitioner | 12303 Ne 130th Ln, Ste400, Kirkland, WA 98034-3099 | 2015-07-19 |
| 1770913055 | Jocelyn Halverson | Nurse Practitioner | 12303 Ne 130th Ln, Ms 26, Kirkland, WA 98034-3099 | 2013-11-22 |
| 1205137213 | Jennifer Anne Hamblett Mohr | Advanced Practice Midwife | 12303 Ne 130th Ln, Suite 225, Kirkland, WA 98034-3099 | 2010-11-07 |
| 1447563267 | Lisa Marguerite Arnold | Advanced Practice Midwife | 12303 Ne 130th Ln, Suite 500, Kirkland, WA 98034-3099 | 2010-07-21 |
| 1801107271 | Misung Kim | Internal Medicine | 12303 Ne 130th Ln, Suite 250, Kirkland, WA 98034-3099 | 2010-06-30 |
| 1497988505 | Quyen T Stevenson | Nurse Practitioner | 12303 Ne 130th Ln, Suite 400, Kirkland, WA 98034-3099 | 2009-08-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508384371 | Shane Robert Egresi | Physician Assistant | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2017-08-31 |
| 1306295936 | Jennifer Nicole Bienz | Physician Assistant | 11800 Ne 128th St Ste 300, Evergreenhealth Plaza Building, Kirkland, WA 98034-7211 | 2016-06-04 |
| 1548698442 | Amanda R Cordes | Physician Assistant | 12707 120th Ave Ne, Suite 203, Kirkland, WA 98034-7500 | 2013-10-31 |
| 1548607450 | Alan Itkin Pllc | Physician Assistant | 11656 98th Ave Ne, Kirkland, WA 98034-4216 | 2013-05-31 |
| 1427300565 | Sarah Severance Goble | Physician Assistant | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2012-10-14 |
| 1528397569 | Devin Shawn Jensen | Physician Assistant | 12707 120th Ave Ne, #203, Kirkland, WA 98034-7500 | 2009-12-22 |
| 1982892345 | Megan E Landis Ferestien | Physician Assistant | 12911 120th Ave Ne Ste G100, Kirkland, WA 98034 | 2007-10-11 |
| 1497855308 | Gary Beerman | Physician Assistant | 3100 Carillon Pt, Kirkland, WA 98033-7306 | 2006-09-22 |
| 1265410260 | Patti Anne Quick Showalter | Physician Assistant | 12910 Totem Lake Blvd Ne Ste 102, Kirkland, WA 98034-2901 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.