Ms Nicole Autumn Pine, PA-C - Medicare Physician Assistant in Olympia, WA

Ms Nicole Autumn Pine, PA-C is a medicare enrolled "Physician Assistant" physician in Olympia, Washington. She graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Dispatchhealth Washington Pc, King County Public Hospital District No 2 and her current practice location is 3920 Capital Mall Dr Sw, Suite 400, Olympia, Washington. You can reach out to her office (for appointments etc.) via phone at (360) 705-1259.

Ms Nicole Autumn Pine is licensed to practice in Washington (license number 60993143) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457818239.

Contact Information

Ms Nicole Autumn Pine, PA-C
3920 Capital Mall Dr Sw, Suite 400,
Olympia, WA 98502
(360) 705-1259
(360) 705-2757



Physician's Profile

Full NameMs Nicole Autumn Pine
GenderFemale
SpecialityPhysician Assistant
Experience5 Years
Location3920 Capital Mall Dr Sw, Olympia, Washington
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Nicole Autumn Pine graduated from medical school in 2019
  NPI Data:
  • NPI Number: 1457818239
  • Provider Enumeration Date: 02/27/2019
  • Last Update Date: 02/23/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3870823560
  • Enrollment ID: I20190923002851

Medical Identifiers

Medical identifiers for Ms Nicole Autumn Pine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457818239NPI-NPPES
2137050MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 60993143 (Washington)Secondary
363A00000XPhysician Assistant 60993143 (Washington)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Tacoma General Allenmore HospitalTacoma, WAHospital
Evergreenhealth Medical CenterKirkland, WAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Dispatchhealth Washington Pc206276542364
King County Public Hospital District No 27618880097481

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Nicole Autumn Pine is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Nicole Autumn Pine, PA-C
3920 Capital Mall Dr Sw, Suite 400,
Olympia, WA 98502

Ph: (360) 705-1259
Ms Nicole Autumn Pine, PA-C
3920 Capital Mall Dr Sw, Suite 400,
Olympia, WA 98502

Ph: (360) 705-1259

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