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NPI Code Detail

MEDICARE: ILANA ADINA SIMON PA-C

MEDICARE: ILANA ADINA SIMON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant60661878WA
2363A00000XPhysician AssistantPA60661878WA
3363A00000XPhysician Assistant64040CA

General Provider Information

NPI Number : 1073966966
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA ADINA SIMON PA-C
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 425-304-8431
Fax Number :
Provider Business Practice Location Address
First Line : 1200 112TH AVE NE STE C160
Second Line :
City : BELLEVUE
State : WA
Zip : 98004-3742
Country : US
Telephone Number : 425-453-1039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2016
Last Update Date : 03/17/2026

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Directions to “ ILANA ADINA SIMON PA-C” Practice Location

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