VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS


Address: 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644
Phone: 3602564425

VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS (NPI# 1558552380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558552380
Entity Type Organization
Organization Name VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS
Other Organization Name VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CENTER
Practice Address 1405 Se 164th Ave
Suite 102
Vancouver
WA 98683-9644
Practice Telephone 3602564425
Practice Fax Number 3602607249
Mailing Telephone 3602564425
Mailing Fax Number 3602607249
Enumeration Date 2007-08-07
Last Update Date 2007-08-07
Authorized Official Name MR. NATHAN J GEIGLE (PRACTICE MANAGER)
Authorized Official Telephone 3604496612
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
WA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WA 7092885 05

Other Provider/Organization Names

Other Name Type Code
Vancouver Ear, Nose & Throat Head & Neck Surgery Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1649461476 Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps Clinic/Center 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644 2007-08-07
1912198748 Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps Clinic/Center 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 2007-08-07
1821289653 Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps Clinic/Center 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 2007-08-07

Office Location

Street Address 1405 SE 164TH AVE
SUITE 102
City VANCOUVER
State WA
Zip Code 98683-9644

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689669475 Donald John Benz Family Medicine 1405 Se 164th Ave, Suite 201, Vancouver, WA 98683-9644 2005-09-16
1013109115 Canepa Dental, LLC Dentist 1405 Se 164th Ave, Vancouver, WA 98683-9644 2007-08-13
1649461476 Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps Clinic/Center 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644 2007-08-07
1316147549 Vancouver Ent & Ent of The Northwest, Pllc Hearing Aid Equipment 1405 Se 164th Ave, Ste 102, Vancouver, WA 98683-9644 2007-07-25
1801098868 Michael Lee Workman Specialist 1405 Se 164th Ave, Vancouver, WA 98683-9644 2007-06-01
1821142738 Lisa D Zylstra Physician Assistant 1405 Se 164th Ave, Suite 101, Vancouver, WA 98683-9644 2007-01-22
1164588778 Amna Shebani Dentist 1405 Se 164th Ave, Suite# 203, Vancouver, WA 98683-9644 2006-12-28
1760555445 Eva Nystrom, Arnp, Pllc Clinic/Center 1405 Se 164th Ave, Suite 201, Vancouver, WA 98683-9644 2006-11-17
1780755876 Vancouver Ent and Ent of The Northwest Pllc Clinic/Center 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644 2006-11-13
1417042730 Michael J. Mitchell Otolaryngology 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644 2006-10-03
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NPI Name Taxonomy Address Enumeration
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1447706742 Jennifer Horst Massage Therapist 3401 Se 192nd. Ave. Suite 107, Vancouver, WA 98683 2016-08-28
1154702728 Kacie Marie Hamreus Physician Assistant 3101 Se 192nd Avenue, Vancouver, WA 98683 2015-06-09
1851782338 Kathryn Wiedeman Physical Therapy Assistant 801 Se Park Crestt Ave, Vancouver, WA 98683 2015-02-05
1407255326 Jesse Ryan Moses Dentist 16600 Se 15th Street, Suite A, Vancouver, WA 98683 2014-08-15
1366869893 Stephen J Wold II Podiatrist 16701 Ne Mcgillivray Blvd, Ste 220, Vancouver, WA 98683 2014-03-21
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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1962706655 Advanced Gastroenterology Clinic/Center 2415 Ne 134th St, Suite 205, Vancouver, WA 98686-3025 2011-01-10
1821289653 Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps Clinic/Center 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 2007-08-07
1639268469 Vancouver Ent and Ent of The Northwest Pllc Clinic/Center 14411 Ne 20th Ave Ste 101, Vancouver, WA 98686-6432 2006-10-12
1265527162 Vancouver Ent and Ent of The Northwest Pllc Clinic/Center 1405 Se 164th Ave Ste 102, Vancouver, WA 98683-9644 2006-10-04
1366536880 Southwest Washington Regional Surgery Center, LLC Clinic/Center 200 Ne Mother Joseph Place, Suite 200, Vancouver, WA 98664-3294 2006-10-02

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Competitor

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City VANCOUVER
Zip Code 98683

Improve Information

Please comment or provide details below to improve the information on VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS.

Dataset Information

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.

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