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

Individual provider Physician Assistant · NPI 1356050744

Sydney Fountain, PA-C is a Physician Assistant in Centralia, Washington. Qualified in 2022, 4 years ago. Practices with Providence Health and Services Washington, a 480-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
4
Licensed in
WA
In the registry since
2022
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

1000 S Scheuber Rd
Centralia, WA 98531-8877
Phone: (360) 330-8950
Fax: (360) 330-8955
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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 PA61514013 (WA)

Record details

NPI number1356050744
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 15, 2022
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Providence Health And Services Washington — 480 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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