{"npi":"1275225591","type":"NPI-1","status":"active","name":{"display":"Ms. Kelly Wynn PA-C","other":[{"code":"1","type":"Formerly known as","value":"STADELMAIER, KELLY GLORIA"}],"first":"KELLY","last":"WYNN","middle":"GLORIA","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"WA","license":"PA61460042"}]},"addresses":[{"purpose":"LOCATION","street_1":"825 EASTLAKE AVE E","city":"SEATTLE","state":"WA","postal_code":"981094405","country_code":"US","phone":"2065205000"},{"purpose":"MAILING","street_1":"PO BOX 50095","city":"SEATTLE","state":"WA","postal_code":"981455095","country_code":"US","phone":"2065205700"}],"license":{"state":"WA","number":"PA61460042"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20230822001272","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WA","pac_id":"4789046848"}]},"enumeration_date":"2023-05-24","last_updated":"2025-10-23","_meta":{"source":"NPPES","snapshot_date":"2025-10-23","doc_url":"https://findmynpi.com/api"}}