PACIFIC PHOENIX GROUP PLLC (NPI# 1235765280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235765280 |
| Entity Type | Organization |
| Organization Name | PACIFIC PHOENIX GROUP PLLC |
| Practice Address |
601 Main St Ste 505 Vancouver WA 98660-3414 |
| Mailing Address |
16420 Se Mcgillivray Blvd Ste 103-253 Vancouver WA 98683-3461 |
| Practice Telephone | 3607736340 |
| Mailing Telephone | 4255077848 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Authorized Official Name | DR. OLEG N ZBIRUN (COO) |
| Authorized Official Telephone | 4255077848 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| TMS SERVICES OF VANCOUVER | Doing Business As Name - Organization |
| Street Address |
601 MAIN ST STE 505 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98660-3414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609979558 | Elia R Gonzalez-rodriguez | Psychiatry & Neurology | 601 Main St Ste 505, Vancouver, WA 98660-3414 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538779137 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 781 W Columbia Way, Vancouver, WA 98660 | 2020-08-07 |
| 1538641527 | Melissa Molly Sivaram | Counselor | 1012 Esther St, Vancouver, WA 98660 | 2018-09-05 |
| 1679082598 | Christopher Lewis Schwab | Peer Specialist | 5197 Nw Lower River Rd, Vancouver, WA 98660 | 2017-09-22 |
| 1023560141 | Disabled Veterans Hawaii LLC | Durable Medical Equipment & Medical Supplies | 4817 Nw Fruit Valley Road, Suite 100, Vancouver, WA 98660 | 2016-10-25 |
| 1023493004 | Laura Nicole Wood | Counselor | 1104 Main St Ste M100, Vancouver, WA 98660 | 2015-07-20 |
| 1790034627 | Clark County Juvenile Court | Marriage & Family Therapist | 500 W 11th Street, Vancouver, WA 98660 | 2012-09-06 |
| 1538439104 | Hutton Chiropractic Clinic Inc | Chiropractor | 703 Broadway Street, Ste 650, Vancouver, WA 98660 | 2012-01-12 |
| 1134422629 | Brenda Marie Bible | Social Worker | 101 E 8th St Ste 110, Vancouver, WA 98660 | 2010-12-06 |
| 1871895409 | Donna L Benedicktus | Contractor | 210 E Evergreen Blvd, Vancouver, WA 98660 | 2010-12-02 |
| 1992007801 | Peter Ray Hasemeier | Massage Therapist | 805 Broadway St., Vancouver, WA 98660 | 2010-11-29 |
| Find all providers in zip 98660 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255607818 | Arundhati Undurti | Psychiatry & Neurology | 2525 Ne 139th St # 150, Vancouver, WA 98686-2719 | 2012-03-28 |
| 1487886099 | Preetha S Rosen | Psychiatry & Neurology | 2501 Ne 134th St Ste 203, Vancouver, WA 98686-3028 | 2009-08-14 |
| 1538317524 | Sheela M Choppala-nestor | Psychiatry & Neurology | 14508 Ne 20th Avenue, Suite 305, Vancouver, WA 98686 | 2008-09-03 |
| 1104041813 | Bruce C. Johnson | Psychiatry & Neurology | 748 Se Fairwinds Loop, Vancouver, WA 98661-8087 | 2007-04-16 |
| 1750441929 | Lawrence Young Kim | Psychiatry & Neurology | 1309 Ne 151st Ave, Vancouver, WA 98684-3657 | 2006-12-11 |
| 1356401103 | Rae Wisler | Psychiatry & Neurology | 4603 Ne St Johns Rd, Suite C, Vancouver, WA 98661-2587 | 2006-12-11 |
| 1144311127 | Daniel Francis Lam | Psychiatry & Neurology | 2215 Broadway, Vancouver, WA 98663 | 2006-09-27 |
| 1609979558 | Elia R Gonzalez-rodriguez | Psychiatry & Neurology | 601 Main St Ste 505, Vancouver, WA 98660-3414 | 2006-09-06 |
| 1659340735 | Richard M Shuey | Psychiatry & Neurology | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2006-03-14 |
| 1235117813 | Conrad M Swartz | Psychiatry & Neurology | 12911 Nw 25th Ct, Vancouver, WA 98685-2036 | 2006-01-04 |
| 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.