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

Stephen Kelly, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1235781584

Stephen Kelly, PA-C is a Physician Assistant in Tacoma, Washington. Graduated from University of Utah School of Medicine in 2020, 6 years ago. Licensed in Washington.

Years since qualifying
6
Trained at
University of Utah School of Medicine
Licensed in
WA
In the registry since
2019
Specialties on file
2
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

9040 Jackson Ave
Tacoma, WA 98431-5086
Phone: (609) 774-4071
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 61188032 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1235781584
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 16, 2019
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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