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

MS. Nicole Autumn Pine, PA-C

Individual provider Physician Assistant · NPI 1457818239

MS. Nicole Autumn Pine, PA-C is a Physician Assistant in Seattle, Washington. Qualified in 2019, 7 years ago. Practices with Overlake Medical Clinics LLC, a 426-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
7
Licensed in
WA
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone: (206) 520-5000
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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 PA60993143 (WA)

Record details

NPI number1457818239
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 27, 2019
Last updated in NPPESApril 17, 2024
Certification dateApril 17, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Overlake Medical Clinics Llc — 426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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