Look up the most recent NPI and PECOS records

Kesli Anne Dickens

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1702 Tacoma Ave S Ste A, Tacoma, WA 98402-1700

PECOS Enrollment

This provider is enrolled in PECOS as KESLI DICKENS.

Based on the most recent information from CMS, provider Kesli Anne Dickens is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1124501630
Provider Type
Individual
Full Name
Dickens, Kesli Anne
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/11/2018
Last Updated
3/10/2025

Contact Information

Practice Location

1702 Tacoma Ave S Ste A, Tacoma, WA 98402-1700

(877) 522-1275

(833) 888-7145

Mailing Location

500 SW 7th St Ste A205, Renton, WA 98057-2983

(877) 522-1275

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA61395609 Washington
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 149515 Alaska

Provider Identifiers

ID	Description	Issuer
ID 1704447	Description Medicaid	Issuer Unlisted Alaska
ID 149515	Description Other	Issuer STATE OF ALASKA Alaska

Kesli Anne Dickens

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Bain, Joanna Hope

Moore, Douglas Bernard

Denty, Sara Diane

Bui, Kimberly

Wambuzi, Selemani E

Kaur, Sabreena

Somasundaram, Soundarya

Nguyen, Joanna Le

Fraser, Stephanie Kieu

Zapatka, Jaryd