Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Medina Othman Glenn, PA

Individual provider Physician Assistant · NPI 1841168507

Medina Othman Glenn, PA is a Physician Assistant in Shelton, Washington. Qualified in 2025, 1 year ago. Licensed in Washington.

Years since qualifying
1
Licensed in
WA
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1701 N 13th St
Shelton, WA 98584-2077
Phone: (360) 426-2653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA70040194 (WA)

Record details

NPI number1841168507
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 24, 2025
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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