DEREK SIMMONS (NPI# 1366821993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366821993 |
| Entity Type | Individual |
| Full Name | DEREK SIMMONS |
| Credential | NP |
| Practice Address |
700 Ne 87th Ave # 260 Vancouver WA 98664-1913 |
| Mailing Address |
700 Ne 87th Ave Vancouver WA 98664-1913 |
| Practice Telephone | 3608822778 |
| Mailing Telephone | 3608822778 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP60790052 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2094955 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5000 N Willamette Blvd, Portland, OR 972035743 | 5039437211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467916510 | Derek Simmons | Specialist/Technologist | 7912 Hunt Rd, Springfield, IL 62712-8995 | 2019-01-23 |
| 1730556010 | Derek Xavier Simmons | Counselor | 2 Pittman Ln, Sicklerville, NJ 08081-2009 | 2015-08-21 |
| Street Address |
700 NE 87TH AVE # 260 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98664-1913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619482551 | Jennessa Victoria Offutt | Registered Nurse | 700 Ne 87th Ave # 260, Vancouver, WA 98664-1913 | 2017-12-13 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942711767 | Julie B Lawrence | Nurse Practitioner | 900 Ne 139th Street, Suite 202, Vancouver, WA 98685 | 2017-10-19 |
| 1588174833 | Oliver Uy | Nurse Practitioner | 15814 Ne 72nd, Vancouver, WA 98682 | 2017-10-01 |
| 1780103549 | Rebecca Adele Rutledge | Nurse Practitioner | 10503 Ne 67th Ave, Vancouver, WA 98686-5103 | 2017-09-13 |
| 1689044182 | Moonstone Medical Group, Pllc | Nurse Practitioner | 9320 Ne Vancouver Mall Dr, Suite 103, Vancouver, WA 98662-8203 | 2015-09-28 |
| 1306155270 | Christie Anne Kratovil | Nurse Practitioner | 8614 E Mill Plain Blvd Ste 310, Vancouver, WA 98664-2058 | 2010-09-27 |
| 1780822916 | Stephanie Renee Jones | Nurse Practitioner | 406 Se 131st Ave Ste 203, Vancouver, WA 98683-4013 | 2009-01-26 |
| 1942484308 | Chrissie Collette Russell-wilson | Nurse Practitioner | 501 Se 172nd Ave Ste 130, Vancouver, WA 98684 | 2007-12-20 |
| 1093831752 | Sherrie Lee Thomas | Nurse Practitioner | Cascade Park Medical Office. 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2007-03-22 |
| 1669575692 | Debra Ann Goldstein | Nurse Practitioner | 12607 S.e. Mill Plain Blvd., Vancouver, WA 98684 | 2006-09-06 |
| 1780611061 | Laura Susana Serna | Nurse Practitioner | 9102 Ne Highway 99, Vancouver, WA 98665-8925 | 2006-06-26 |
| 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.