{"npi":"1033548144","type":"NPI-1","status":"active","name":{"display":"Fantahun Tedla P.A-C","other":[],"first":"FANTAHUN","last":"TEDLA","middle":"MULUGETA","credential":"P.A-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"WV","license":"623"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"WA","license":"PA60464318"}]},"addresses":[{"purpose":"LOCATION","street_1":"3927 RUCKER AVE","city":"EVERETT","state":"WA","postal_code":"98201","country_code":"US","phone":"4253395422","fax":"4253395444"},{"purpose":"MAILING","street_1":"PO BOX 5127","city":"EVERETT","state":"WA","postal_code":"982065127","country_code":"US","phone":"4253395422","fax":"4253395444"}],"license":{"state":"WA","number":"PA60464318"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20140718001605","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WA","pac_id":"2668602996"}]},"enumeration_date":"2013-11-08","last_updated":"2019-11-15","_meta":{"source":"NPPES","snapshot_date":"2019-11-15","doc_url":"https://findmynpi.com/api"}}