TONI LUCILLE STORM-DICKERSON (NPI# 1104910850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104910850 |
| Entity Type | Individual |
| Full Name | TONI LUCILLE STORM-DICKERSON |
| Other Name | ANTOINETTE LUCILLE STORM |
| Credential | MD |
| Practice Address |
210 Se 136th Ave Vancouver WA 98684-6930 |
| Practice Telephone | 3609449889 |
| Practice Fax Number | 3609449686 |
| Mailing Telephone | 3609449889 |
| Mailing Fax Number | 3609449686 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MD00042022 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1036230 | 05 | |
| OR | 275562 | 05 |
| Street Address |
210 SE 136TH AVE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-6930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508869546 | Matthew Charles Brouns | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-05-23 |
| 1194103176 | Marisa Osorio Gholson | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2015-05-11 |
| 1083991103 | Stephanie Brie Hudson | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2011-11-03 |
| 1851694202 | Tracy Lynn Webb | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2010-12-07 |
| 1114229374 | Joyce Marie Koerber | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2010-11-21 |
| 1942416524 | Nora Jane Bucher | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684 | 2007-05-14 |
| 1861567562 | David Peter Cosgrove | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-11-21 |
| 1750463485 | Dan Morris Hyder | Pathology | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-10-20 |
| 1629062542 | Magdolna Solti | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-09-07 |
| 1528061181 | David Allen Smith | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-05-27 |
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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 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659858132 | Vancouver Vein & Surgical Center | Surgery | 13115 Ne 4th St Ste 230, Vancouver, WA 98684-5965 | 2018-07-26 |
| 1407008279 | Sam Hassan, Md | Surgery | 14614 Nw Seward Rd, Vancouver, WA 98685-1519 | 2008-10-10 |
| 1316152457 | Thomas S Dietrich | Surgery | 5009 Dubois Dr, Vancouver, WA 98661-6612 | 2007-05-11 |
| 1386728046 | Janet Lynne Strong | Surgery | 300 E 37th St, Vancouver, WA 98663-2212 | 2006-10-25 |
| 1760405310 | Michelle Dione Taylor | Surgery | 2101 Ne 139th Street, Mob B Suite 260, Vancouver, WA 98686-2742 | 2006-07-25 |
| 1437129012 | Jamie S Khaw | Surgery | 8614 E Mill Plain #201, Vancouver, WA 98664 | 2006-01-25 |
| 1750794517 | Reid Fletcher | Surgery | 2525 Ne 139th St Ste 260, Vancouver, WA 98686-2719 | 2014-06-09 |
| 1821351099 | Yuxuan Jerry Wang | Surgery | 505 Ne 87th Ave Ste 301, Vancouver, WA 98664-1965 | 2012-06-21 |
| 1366738312 | Brian Joseph Zeithaml | Surgery | 505 Ne 87th Ave Ste 301, Vancouver, WA 98664-1965 | 2011-06-28 |
| 1265759708 | Columbia Eyecare PC | Surgery | 12306 Se Mill Plain Blvd, Suite 100, Vancouver, WA 98684-6061 | 2010-04-23 |
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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.