DR. JACK E LONG (NPI# 1366480949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366480949 |
Entity Type | Individual |
Full Name | DR. JACK E LONG |
Credential | MD |
Practice Address |
100 E 33rd St Ste 100 Vancouver WA 98663-2776 |
Mailing Address |
Po Box 1600 Vancouver WA 98668-1600 |
Practice Telephone | 3602562000 |
Practice Fax Number | 3605147553 |
Mailing Telephone | 3605147550 |
Mailing Fax Number | 3605147553 |
Enumeration Date | 2006-06-03 |
Last Update Date | 2008-02-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | MD00028913 | WA | Allopathic & Osteopathic Physicians |
N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MD00028913 | WA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 8131195 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184792129 | Jack A Long | Chiropractor | 2893 E Green Canyon Dr, Meridian, ID 83642-9105 | 2006-11-30 |
1447296629 | Jack Martin Long | Social Worker | 720c Maiden Choice Ln, Catonsville, MD 21228-5940 | 2006-06-22 |
1861918534 | Jack Long | Physical Therapist | 425 Waverley Oaks Rd, Waltham, MA 02452-8448 | 2017-08-15 |
1376534917 | Jack Calhoun Long | Specialist | 1900 Scenic Dr, Suite 3318, Georgetown, TX 78626-7724 | 2005-11-02 |
Street Address |
100 E 33RD ST STE 100 |
City | VANCOUVER |
State | WA |
Zip Code | 98663-2776 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457971244 | Charis Mok | Family Medicine | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2020-04-21 |
1043830045 | Diego Aviles | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2020-04-20 |
1689293730 | Angela Rofelty | Family Medicine | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2020-04-09 |
1235777269 | Jenna Danielle Stevens | Physician Assistant | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-12-20 |
1033773775 | Martin Robert Box | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-29 |
1508420456 | Kristen Anne Tremaine | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-25 |
1295398691 | Jordan Robert Albrich | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-21 |
1508429093 | Samual Kelly Lavis | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-19 |
1427611102 | Jacqueline Blacnche Berglass | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-17 |
1891258331 | Curtis Papenfuss | Student in an Organized Health Care Education/Training Program | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2019-04-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053946673 | Jessica Maree Carnes | Dental Hygienist | 6505 Nw Cherry Street, Vancouver, WA 98663 | 2020-03-04 |
1598247207 | Kristine Marie Mcginley | Acupuncturist | 100 East 33rd St., Ste 203a, Vancouver, WA 98663 | 2018-08-30 |
1932689460 | Jennifer Fowler | Behavioral Analyst | 1901 Broadway St Apt 103, Vancouver, WA 98663 | 2018-08-15 |
1083109755 | Kallie A Wikman | Physical Therapist | 100 E 33rd St Ste 204, Vancouver, WA 98663 | 2018-06-26 |
1407344872 | Kyle Besaw | Student in an Organized Health Care Education/Training Program | 300 E 33rd St Ste 100, Vancouver, WA 98663 | 2018-05-01 |
1023521747 | Focal Clinic Inc | Counselor | 3305 Main St Ste 205, Vancouver, WA 98663 | 2017-11-16 |
1215455365 | Thirty Three Oaks, LLC | Skilled Nursing Facility | 400 E. 33rd St., Vancouver, WA 98663 | 2017-09-08 |
1174047690 | Douglas Gangat Uy | Counselor | 1610 C Street, Suite 102, Vancouver, WA 98663 | 2017-07-26 |
1699206243 | Maggie May Mcgraw | Social Worker | 410 E 20th Street, Vancouver, WA 98663 | 2017-03-24 |
1356740328 | Joseph Kelly | Dentist | 1008 Nw 59th St., Vancouver, WA 98663 | 2014-08-15 |
Find all providers in zip 98663 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386039550 | Sean Vikram Bhatia | Internal Medicine | Kaiser Salmon Creek, 14406 Ne 20th Ave, Vancouver, WA 98686 | 2015-04-03 |
1609215987 | Sonam Ravindra Kiwalkar | Internal Medicine | 700 Ne 87th Ave Ste 330, Vancouver, WA 98664-4896 | 2013-06-19 |
1205279585 | Marla Mcknight | Internal Medicine | St. Paul's Hospital, 1081 Burrard Street, Vancouver, BRITISH COLUMBIA V6Z1Y6 | 2013-04-16 |
1245577675 | John Adam Staples | Internal Medicine | 1081 Burrard St, Room 5910b, Vancouver, BC V6Z1Y6 | 2013-01-04 |
1598051252 | Joshua Grant | Internal Medicine | 200 Ne Mother Joseph Pl Ste 400, Vancouver, WA 98664-3290 | 2011-06-21 |
1235422023 | Gurleen Dhami | Internal Medicine | 8821 Ne 5th St, Vancouver, WA 98664 | 2011-05-26 |
1487810073 | Charul Sen | Internal Medicine | 2101 Ne 139th St Ste 460, Vancouver, WA 98686-2325 | 2008-08-02 |
1730351529 | Troy Harris Dillard | Internal Medicine | 2312 Ne 129th St Ste 120, Vancouver, WA 98686-3236 | 2008-04-01 |
1538381884 | Vancouver Primary Care Ps | Internal Medicine | 11719 Ne 95th St, Suite F, Vancouver, WA 98682-2444 | 2007-05-03 |
1821115064 | Elaheh N. Tehranchi | Internal Medicine | 2525 Ne 139th St Ste 230, Vancouver, WA 98686 | 2007-03-23 |
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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.