MR. JACK ALLAN SOM (NPI# 1295954998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295954998 |
| Entity Type | Individual |
| Full Name | MR. JACK ALLAN SOM |
| Credential | RNFA |
| Practice Address |
Medical Center 400 Ne Mother Joseph Place Vancouver WA 98668-9989 |
| Mailing Address |
16506 Ne 28th Ave Ridgefield WA 98642-8958 |
| Practice Telephone | 3605142000 |
| Mailing Telephone | 3606092898 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP2800X |
Clinical Nurse Specialist Specialization: Perioperative |
RN00061877 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | REGISTERED NURSE | RN00061877 | 01 |
| Street Address |
MEDICAL CENTER 400 NE MOTHER JOSEPH PLACE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98668-9989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548507429 | Susan Diane Orthel | Speech-Language Pathologist | 13501 Ne 28th St., Evergreen Public Schools, Vancouver, WA 98668 | 2013-01-11 |
| 1225267032 | Eunita Rankins | Counselor | 1601 East Fourth Plain Blvd, Vancouver, WA 98668 | 2009-07-14 |
| 1902003387 | Jessica Marie Spencer | Counselor | 1601 E Fourth Plain Blvd., Vancouver, WA 98668 | 2007-06-29 |
| 1982631149 | Brenda Jill Keirnan | Registered Nurse | 400 Mother Joseph Place, Southwest Washington Medical Center, Vancouver, WA 98668 | 2006-06-26 |
| 1407893001 | Caleb Liem | Obstetrics & Gynecology | 8716 E Mill Plain Blvd, Relief Position Only, Vancouver, WA 98668 | 2006-06-01 |
| 1588646228 | Mohiedean Ghofrani | Pathology | Sw Washington Medical Center, Vancouver, WA 98668 | 2005-11-17 |
| 1982721858 | Teresa H Lam | Family Medicine | 400 Ne Mother Joseph Place, Cogent Inpatient Services, Vancouver, WA 98668 | 2007-03-23 |
| 1972845626 | Nancy J Garrett | Speech-Language Pathologist | 13501 Ne 28th St., Vancouver, WA 98668-8910 | 2013-03-20 |
| 1750385738 | Douglas Robert Newport | Nurse Anesthetist, Certified Registered | 400 Ne Mother Joseph Pl., Sw Washington Med Center,fbc-anesthesia, Vancouver, WA 98668-9989 | 2005-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558743 | Erin Claire Stafford | Massage Therapist | 709 Nw 120th St, Vancouver, WA 98685-2495 | 2020-11-03 |
| 1437759230 | Valeria M Panibratets | Naturopath | 10411 Ne 21st Ct, Vancouver, WA 98686-5990 | 2020-10-30 |
| 1548860307 | Vancouver Voice Works Pllc | Speech-Language Pathologist | 12707 Ne 37th St, Vancouver, WA 98682-7923 | 2020-10-29 |
| 1184223661 | Marisol Wilson | Interpreter | 703 W Fourth Plain Blvd, Vancouver, WA 98660-2014 | 2020-10-26 |
| 1154920007 | Gabriela Garcia | Interpreter | 5500 Ne Fourth Plain Blvd Apt 179, Vancouver, WA 98661-6853 | 2020-10-21 |
| 1629677000 | Tracy Lynnette Valentine | Doula | 5717 Ne 135th Ave, Vancouver, WA 98682-5974 | 2020-10-18 |
| 1508463878 | Andrew Accornero | Counselor | 108 Se 124th Ave Ste 17, Vancouver, WA 98684-6015 | 2020-10-08 |
| 1316544711 | Rachel Skiles | Registered Nurse | 11328 Ne 51st Cir Apt J96, Vancouver, WA 98682-1209 | 2020-10-08 |
| 1376140418 | Lana Michelle Ferris | Naturopath | 1404 Ne 134th St Ste 180c, Vancouver, WA 98685-2799 | 2020-10-01 |
| 1629685466 | Jazmin Keymolen | Behavioral Analyst | 9901 Ne 7th Ave Unit C-16, Vancouver, WA 98685-4523 | 2020-09-25 |
| Find all providers in VANCOUVER | ||||
| Taxonomy Code | 364SP2800X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Perioperative |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407916182 | Kylene Denise Stengel | Clinical Nurse Specialist | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710321419 | Renee Michelle Sullivan | Clinical Nurse Specialist | 1506 W 46th Ave, Kennewick, WA 99337-3935 | 2013-04-24 |
| 1962697813 | Joan Thompson | Clinical Nurse Specialist | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2007-09-12 |
Please comment or provide details below to improve the information on MR. JACK ALLAN SOM.
| 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.