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

Samra Ejaz Khan

Individual provider Physician Assistant · NPI 1639650781

Samra Ejaz Khan is a Physician Assistant in Kent, Washington. Qualified in 2019, 7 years ago. Practices with Kaiser Foundation Health Plan of Washington, a 1,519-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
7
Licensed in
WA
In the registry since
2018

Practice location Address checks out

26004 104th Ave SE
Kent, WA 98030-7677
Phone: (425) 251-4040
Fax: (425) 251-4126
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA61007133 (WA)

Record details

NPI number1639650781
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 27, 2018
Last updated in NPPESApril 22, 2021
Certification dateApril 22, 2021
Mailing address26004 104th Ave Se, Kent, WA 98030-7677

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 Kaiser Foundation Health Plan Of Washington — 1519 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Kent