FIDEL HERNANDEZ JR. (NPI# 1104461961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104461961 |
| Entity Type | Individual |
| Full Name | FIDEL HERNANDEZ JR. |
| Credential | ARNP |
| Practice Address |
12607 Se Mill Plain Blvd Vancouver WA 98684-6055 |
| Mailing Address |
13216 Ne Salmon Creek Ave Unit H4 Vancouver WA 98686-2887 |
| Practice Telephone | 8008132000 |
| Mailing Telephone | 3609108336 |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP61085876 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12607 SE MILL PLAIN BLVD |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-6055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659340735 | Richard M Shuey | Psychiatry & Neurology | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2006-03-14 |
| 1447883020 | Kendra M Latimer | Case Manager/Care Coordinator | 12607 Se Mill Plain Blvd, Vancouver, WA 98684 | 2020-02-21 |
| 1285273086 | Leayn N Vandeven | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-12-27 |
| 1528605342 | Jeff Cooksey | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-12-01 |
| 1518516822 | Tameca Vernee Pryce | Respiratory Therapist, Certified | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-09-09 |
| 1700348042 | Beredu Abraham Geleto | Registered Nurse | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-04-04 |
| 1942772660 | Patricia Maria Rivera | Psychologist | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-12-19 |
| 1992288328 | Irene Moulton | Pharmacist | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-09-12 |
| 1962982348 | Christina Kirkpatrick | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-08-15 |
| 1346729589 | Megan Breanne Short | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-08-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417423989 | Magnolia Psychiatric Services Pllc | Nurse Practitioner | 10000 Ne 7th Ave Ste 330f, Vancouver, WA 98685-4561 | 2018-10-22 |
| 1811408297 | Tms Nw Pllc | Nurse Practitioner | 5512 Ne 109th Ct Ste N, Vancouver, WA 98662-6175 | 2017-10-12 |
| 1164967246 | Ashley Leinani Bolan | Nurse Practitioner | 601 E 22nd St Ste C, Vancouver, WA 98663-3208 | 2016-12-28 |
| 1023455938 | Adina D Tarpley | Nurse Practitioner | 7210 Ne 14th Ct, Vancouver, WA 98665-0415 | 2013-05-31 |
| 1346428125 | Richard Stuart Keyser | Nurse Practitioner | 3305 Main St Ste 201, Vancouver, WA 98663-2250 | 2008-02-04 |
| 1407981095 | Kim L Carnahan Lewis | Nurse Practitioner | 1601 E Fourth Plain Blvd Bldg 17, Suite B222, Vancouver, WA 98661-3753 | 2007-02-22 |
| 1750318788 | Susan S. Rose | Nurse Practitioner | Legacy Salmon Creek Providers, 2211 Ne 139th Street, Vancouver, WA 98686-2742 | 2006-06-26 |
| 1073572269 | Julie A Dewitt-kamada | Nurse Practitioner | 3208 Ne 141st St, Vancouver, WA 98686-2260 | 2006-03-17 |
| 1821073081 | Janet Nickolaus | Nurse Practitioner | 2300 E Mill Plain Blvd, Vancouver, WA 98661-4332 | 2005-12-09 |
| 1285233627 | Kristy Hosley | Nurse Practitioner | 5512 Ne 109th Ct Ste I, Vancouver, WA 98662-6175 | 2020-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.