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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ETINOSA LOPEZ EBAGUA PA-C
NPI 1700655701
Physician Assistant - Medical in Othello, WA

Active since January 01, 2024
1515 E COLUMBIA ST, OTHELLO, WA 99344(509) 488-5256(509) 488-9939 Get Directions Write a Review

NPPES record last updated: October 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 16, 2026, Sep 11, 2025, Jan 1, 2024 (3 updates tracked since 2024).

About Etinosa Lopez Ebagua Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETINOSA LOPEZ EBAGUA PA-C (NPI 1700655701) is an individual medical provider in Othello, Washington, licensed in Washington (PA70190314) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1700655701
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameETINOSA LOPEZ EBAGUACredential: PA-C
Location Address1515 E COLUMBIA STOthello, WA 99344-1846
Mailing Address1515 E Columbia StOthello, WA 99344-1846 · (509) 488-5256 · Fax (509) 488-9939
Phone(509) 488-5256
Fax(509) 488-9939
Sole ProprietorNo
Enumeration DateJanuary 1, 2024
Last NPPES UpdateOctober 16, 20263 updates tracked since enumeration
NPPES CertifiedOctober 16, 2026
✔ NPI 1700655701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in WA · PA70190314
1515 E COLUMBIA ST, Othello, WA 99344
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA ELY
Nurse Practitioner (Family)
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
HEERA GOVINDARAJAN VENGUIDESVARANE DDS
Dentist
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
MIKAYLA E ALONZO RDH
Dental Hygienist
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
COLUMBIA BASIN HEALTH ASSOCIATION
Clinic/Center (Federally Qualified Health Center (FQHC))
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
DR. JI HYUNG CHOI D.D.S.
Dentist (General Practice)
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
STEVEN PITCHER DDS
Dentist
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
SAMANTHA JO ESLINGER
Dental Hygienist
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256
MICHELLE MARTINEZ
Nurse Practitioner (Psychiatric/Mental Health)
1515 E COLUMBIA ST
OTHELLO, WA 99344
Adams County (509) 488-5256

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Etinosa Ebagua's NPI number?

The NPI number for Etinosa Ebagua is 1700655701. It was assigned to this individual provider in the NPPES registry on January 1, 2024.

Where is Etinosa Ebagua located?

Etinosa Ebagua practices at 1515 E Columbia St, Othello, WA 99344. The listed phone number is (509) 488-5256.

What is Etinosa Ebagua's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Etinosa Ebagua was last updated on October 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.