Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1780302828 Individual Practitioner Female Practitioner

Kylie Raeann Black , PA-C

Physician Assistant • Monroe, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kylie Black, PA-C is a certified Physician Assistant practicing in Monroe, WA. With approximately 3 years of clinical experience since completing medical education in 2023, Kylie Black delivers high-quality medical care to the local community at 17707 W MAIN ST FL 1.

Kylie Black is affiliated with Sea Mar Community Health Centers and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

17707 W Main St Fl 1

Monroe, WA 982721967

Telephone 3602823885
Fax 3605122026
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Monroe, WA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -10.1 yrs vs City Avg
City Avg: 13.1 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
10 Specialists

Practicing in Monroe, WA (3774 Statewide)

Telehealth Adoption Rate
40.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Black (3 Years) 3 Yrs
Monroe Specialty Average (13.1 Years) 13.1 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-09-04
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA61482872

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Sea Mar Community Health Centers

17707 W Main St, Monroe, WA 982721967

Phone: 3602823885

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Evan Teplow , MD

Family Medicine

NPI 1063497089

Doctor of Medicine (M.D.)

Lisa John , ARNP

Nurse Practitioner - Family

NPI 1235961723

Advanced Registered Nurse Practitioner

Alisa Chard , FNP

Nurse Practitioner - Family

NPI 1235964107

Family Nurse Practitioner

Dr. Savannah Tart , DNP

Nurse Practitioner - Family

NPI 1356931992

Doctor of Nursing Practice

Adama Barry , ARNP

Nurse Practitioner - Family

NPI 1518839141

Advanced Registered Nurse Practitioner

Thepthara Pholsena

Nurse Practitioner - Adult Health

NPI 1588932495

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
👤
Provider Name / Credentials Updated September 04, 2024

Recorded as KYLIE BLACK, PA-C

📍
Updated Practice Location April 23, 2024

Registered at 17707 W MAIN ST FL 1, MONROE, WA 982721967 (Tel: 3602823885)

📍
Updated Business Mailing Address April 23, 2024

Registered at PO BOX 34703, SEATTLE, WA 981241703 (Tel: 5368166262)

👤
Provider Name / Credentials Updated April 23, 2024

Recorded as KYLIE CARTER, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2024

Physician Assistant (License #PA61482872 in WA)

NPI Profile Active August 15, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location August 15, 2022

Registered at 4311 11TH AVE NE STE 200, SEATTLE, WA 981056367 (Tel: 2066164001)

📍
Updated Business Mailing Address August 15, 2022

Registered at 4311 11TH AVE NE STE 200, SEATTLE, WA 981056367 (Tel: 2066164001)

👤
Provider Name / Credentials Updated August 15, 2022

Recorded as KYLIE CARTER, PA-S

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration August 15, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780302828
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2022
Last Update: September 04, 2024
Sole Proprietor: No

Mailing Address

Po Box 34703

Seattle, WA 981241703

Phone: 5368166262

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.