Individual ProviderMichaela EthertonPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address200 NE Mother Joseph Pl Ste 300, Vancouver, WA 98664-3296(360) 254-6161PECOS EnrollmentBased on the most recent information from CMS, provider Michaela Etherton is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1619586153Provider TypeIndividualFull NameEtherton, MichaelaCredentialPA-SGenderFemaleSole ProprietorNoEnumeration Date7/30/2020Last Updated1/16/2026Contact InformationPractice LocationPractice Address200 NE Mother Joseph Pl Ste 300, Vancouver, WA 98664-3296Phone(360) 254-6161Fax(360) 803-0847Mailing LocationMailing Address200 NE Mother Joseph Pl Ste 210, Vancouver, WA 98664-3295Phone(360) 254-6161Fax(360) 803-0847Provider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA61229907WashingtonCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA61229907Washington