TRACY ANN RIESENBERGER (NPI# 1790136554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790136554 |
| Entity Type | Individual |
| Full Name | TRACY ANN RIESENBERGER |
| Credential | PA-C |
| Practice Address |
550 17th Ave Fl 5 Seattle WA 98122 |
| Mailing Address |
Po Box 25608 Salt Lake City UT 84125-0608 |
| Practice Telephone | 2063202800 |
| Practice Fax Number | 2063202827 |
| Mailing Telephone | 2063204476 |
| Mailing Fax Number | 2065687043 |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2018-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60805561 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
550 17TH AVE FL 5 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538150800 | Lovelle O. Ralls | Nurse Practitioner | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2005-11-04 |
| 1346703543 | Maisa Ann Rouzer | Registered Nurse | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2019-04-13 |
| 1780168880 | Sahar Etebar | Registered Nurse | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2018-09-24 |
| 1427501162 | Ashish Patel | Nurse Practitioner | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2016-07-29 |
| 1932581295 | Pouriya Ghayoumi | Orthopaedic Surgery | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2015-06-23 |
| 1881081560 | Christopher L Ideen | Physical Medicine & Rehabilitation | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2015-04-21 |
| 1053726000 | Ryan M Goodmanson | Orthopaedic Surgery | 550 17th Ave Fl 5, Seattle, WA 98122 | 2014-06-29 |
| 1861802126 | Benjamin Alexander Schell | Orthopaedic Surgery | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2014-05-07 |
| 1306198536 | Joanna Marie Rives | Nurse Practitioner | 550 17th Ave Fl 5, Swedish Neuroscience Institute, Seattle, WA 98122-5788 | 2012-10-11 |
| 1801155767 | Amir Abdul-jabbar | Orthopaedic Surgery | 550 17th Ave Fl 5, Seattle, WA 98122-5788 | 2012-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| Find all providers in zip 98122 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851875561 | Sarah Gene Soloff | Physician Assistant | 9730 3rd Ave Ne Ste 201, Seattle, WA 98115-2023 | 2018-09-18 |
| 1861987992 | Lillian Baldwin Bourret | Physician Assistant | 6317 Linden Ave N, Seattle, WA 98103-5658 | 2018-07-01 |
| 1043535024 | Pamela Baird | Physician Assistant | 2016 16th Ave East, Seattle, WA 98112-5260 | 2010-04-01 |
| 1548402209 | Loverne Greg De Venecia Jimenez | Physician Assistant | James Tower 550 17th Ave Suite 500, Swedish Neuroscience Institute, Seattle, WA 98122 | 2009-03-27 |
| 1679506737 | Gerald M Strode | Physician Assistant | 521 Wall St, Seattle, WA 98121-1524 | 2006-07-09 |
| 1023049905 | Kari A. Schmitz | Physician Assistant | 3725 Sw Prescott Pl, Seattle, WA 98126-2042 | 2006-07-06 |
| 1528007069 | Claudia M Kalotay | Physician Assistant | 901 Boren Ave #800, Seattle, WA 98104 | 2006-06-06 |
| 1386681815 | Paul Richard Halkett | Physician Assistant | Pbs Building, 401 Broadway, Seattle, WA 98122 | 2006-06-01 |
| 1851361646 | Irina E Penev | Physician Assistant | 550 17th Ave Fl 6, Seattle, WA 98122-5788 | 2006-01-24 |
| 1174123939 | Kaitlin C Fitzgerald | Physician Assistant | 325 9th Ave, Seattle, WA 98104-2420 | 2020-10-29 |
| Find all providers in SEATTLE | ||||
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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.