JENNY LOU ELDREDGE (NPI# 1164804647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164804647 |
| Entity Type | Individual |
| Full Name | JENNY LOU ELDREDGE |
| Other Name | JENNY LOU HARRIS |
| Practice Address |
400 Ne Mother Joseph Place Vancouver WA 98664 |
| Practice Telephone | 3602562000 |
| Mailing Telephone | 3602562000 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
400 NE MOTHER JOSEPH PLACE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184662611 | Roxana Volynets | Physician Assistant | 400 Ne Mother Joseph Place, Vancouver, WA 98664-3200 | 2006-06-04 |
| 1306165063 | Rebika Bijukchhe | Internal Medicine | 400 Ne Mother Joseph Place, Southwest Washington Medical Center, Vancouver, WA 98664 | 2010-05-20 |
| 1194989723 | Kashiff Khan | Family Medicine | 400 Ne Mother Joseph Place, Vancouver, WA 98664-3200 | 2008-07-14 |
| 1982721858 | Teresa H Lam | Family Medicine | 400 Ne Mother Joseph Place, Cogent Inpatient Services, Vancouver, WA 98668 | 2007-03-23 |
| 1245309236 | Monique Hapgood | Nurse Practitioner | 400 Ne Mother Joseph Place, Southwest Washington Med Center- Neonatal Icu, Vancouver, WA 98664 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285249938 | Angelica Maria Parle-fresquez | Speech-Language Pathologist | Early Childhood Assessment Center - Lieser School, 301 S. Lieser Rd, Vancouver, WA 98664 | 2020-09-10 |
| 1467923441 | Elizabeth Steen | Counselor | 230 E. State St., Mossyrock, WA 98664 | 2018-12-17 |
| 1497241657 | Chelsey Nicole Parker | Peer Specialist | 9815 Ne 3rd St, Vancouver, WA 98664 | 2018-07-10 |
| 1881145431 | Brent Homan | Occupational Therapist | 807 Se Morgan Rd., Vancouver, WA 98664 | 2016-10-19 |
| 1114474277 | Rebecca Marie Stefan | Nurse's Aide | 10025 Ne 19th St, Vancouver, WA 98664 | 2016-09-07 |
| 1528454105 | Alicia Ford | Dietitian, Registered | 700 Ne 87th Ave Ste 280, Vancouver, WA 98664 | 2015-04-10 |
| 1033504261 | Reid Roberts Bennett | Anesthesiology | 505 Ne 87th Ave Ste 210, Vancouver, WA 98664 | 2015-04-03 |
| 1235550856 | Nikolay Nikolaevich Chernukhin Jr. | Chiropractor | 221-a Ne 104th Ave, Suite 205, Vancouver, WA 98664 | 2013-12-27 |
| 1013278712 | Serena Harker | Physical Therapy Assistant | 221a Ne 104th Ave, Suite #205, Vancouver, WA 98664 | 2012-05-30 |
| 1295091080 | Rebeca C Johnson | Massage Therapist | 11015 Ne 4th Plain Suite B, Vancouver, WA 98664 | 2012-04-05 |
| Find all providers in zip 98664 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457343766 | Laura Deesha Ramme | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 410, Vancouver, WA 98664-3299 | 2005-08-22 |
| 1447720974 | Elizabeth A Eldenburg | Physician Assistant | 505 Ne 87th Ave Ste 250, Vancouver, WA 98664-1965 | 2018-11-27 |
| 1073996823 | Grace Deng | Physician Assistant | 505 Ne 87th Ave, Building A Suite 250, Vancouver, WA 98664-1989 | 2015-06-29 |
| 1194969717 | Mary-colleen D. Zucconi | Physician Assistant | 200 Ne Mother Joseph Pl Ste 110, Vancouver, WA 98664 | 2009-04-27 |
| 1982899365 | Jennifer D Hermes | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 210, Vancouver, WA 98664-3299 | 2007-09-10 |
| 1881702033 | Michael Walter Hibbs | Physician Assistant | 203 Se Park Plaza Dr, Vancouver, WA 98684-5886 | 2006-08-28 |
| 1093751703 | Kyle M. Richter | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| 1225074990 | Bonnie L. Rosenfeld | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| 1285670885 | Brett A. Rasmussen | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| 1912942079 | Christopher E. Carson | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-20 |
| Find all providers in VANCOUVER | ||||
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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.