MS. MARISA OSORIO GHOLSON (NPI# 1194103176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194103176 |
| Entity Type | Individual |
| Full Name | MS. MARISA OSORIO GHOLSON |
| Practice Address |
210 Se 136th Ave Vancouver WA 98684-6930 |
| Mailing Address |
1498 Se Tech Center Pl Ste 240 Vancouver WA 98683-5508 |
| Practice Telephone | 3609449889 |
| Mailing Telephone | 5126499095 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60734980 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA179365 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd # Gh219, Portland, OR 972393011 | 5034943633 | |
| 9555 Sw Barnes Rd, Portland, OR 972256663 | 3605971300 |
| 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 |
| 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 |
| 1104910850 | Toni Lucille Storm-dickerson | Surgery | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-10-03 |
| 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 |
| Find all providers in zip 98684 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760028013 | Nina Mulargia | Physician Assistant | 4912 Ne 54th Ave, Vancouver, WA 98661-2742 | 2019-11-21 |
| 1902387863 | Theodore Rohan Thomas IIi | Physician Assistant | 2370 E 3rd Loop # 203a, Vancouver, WA 98661-7725 | 2018-08-28 |
| 1902310345 | Elowyn Smith | Physician Assistant | 16219 Se 12th St Ste 206, Vancouver, WA 98683-8906 | 2017-11-21 |
| 1154702728 | Kacie Marie Hamreus | Physician Assistant | 3101 Se 192nd Avenue, Vancouver, WA 98683 | 2015-06-09 |
| 1275910929 | Brandon Bruce Mascott | Physician Assistant | 16811 Se Mcgillivray Blvd # 101, Vancouver, WA 98683-3404 | 2015-05-01 |
| 1043614167 | Robyn Elizabeth Nash | Physician Assistant | 812 Se 136th Ave, Unit #l126, Vancouver, WA 98683-6943 | 2014-10-17 |
| 1588935498 | Krista Letsch | Physician Assistant | 14201 Ne 20th Ave Ste 3101, Vancouver, WA 98686-6414 | 2012-01-24 |
| 1528335130 | Jaime Erin Hamilton | Physician Assistant | 900 Ne 139th St Ste 202, Vancouver, WA 98685-2513 | 2011-11-28 |
| 1669760120 | Todd J. Cichosz | Physician Assistant | 2510 Columbia House Blvd, Vancouver, WA 98661-7763 | 2011-07-19 |
| 1992092324 | Jaime Larynn Simpkins | Physician Assistant | 400 Ne Mary Joseph Place, Vancouver, WA 98664 | 2011-07-06 |
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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.