MEDICARE: JANAE VICTORIA XHELILI 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
1	363A00000X	Physician Assistant	PA.PA.70058561	WA

General Provider Information

NPI Number	:	1619718947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANAE VICTORIA XHELILI PA-C

Provider Business Mailing Address
First Line	:	1728 W MARINE VIEW DR STE 111
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98201-2094
Country	:	US
Telephone Number	:	425-259-4041
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 GROVE ST
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4302
Country	:	US
Telephone Number	:	360-653-3500
Fax Number	:	360-657-3268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	04/08/2026

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