MR. JACOB ALEXANDER TIMMERMAN (NPI# 1629350095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629350095 |
| Entity Type | Individual |
| Full Name | MR. JACOB ALEXANDER TIMMERMAN |
| Credential | MA |
| Practice Address |
1014 Main Street Vancouver WA 98661 |
| Practice Telephone | 3606951014 |
| Practice Fax Number | 3607501374 |
| Mailing Telephone | 3606951014 |
| Mailing Fax Number | 3607501374 |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2012-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | OR | Behavioral Health & Social Service Providers |
| Street Address |
1014 MAIN STREET |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053347070 | David Cameron Hunter | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2006-06-23 |
| 1215400296 | Lynn Anne Roberts | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2019-01-02 |
| 1174099881 | Shelby Massingale | 1014 Main Street, Vancouver, WA 98660 | 2018-10-19 | |
| 1568942415 | Nicole Rose Kennedy | Student in an Organized Health Care Education/Training Program | 1014 Main Street, Vancouver, WA 98660 | 2018-08-20 |
| 1053820498 | Kalinda R Ferguson | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2017-09-28 |
| 1154851574 | Aimee Amodio | Social Worker | 1014 Main Street, Vancouver, WA 98660 | 2017-06-18 |
| 1275063737 | Richard Clark | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2017-06-18 |
| 1508307075 | Ezekiel Brouhard | Assistant Behavior Analyst | 1014 Main Street, Vancouver, WA 98660 | 2017-03-16 |
| 1427508639 | Samuel Moore | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2016-10-12 |
| 1144774548 | Kayla Lindsay Klemm | Counselor | 1014 Main Street, Vancouver, WA 98660 | 2016-08-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228417 | Cynthia Ann Holt | Social Worker | 4608 Ne 47 Street, Vancouver, WA 98661 | 2020-06-01 |
| 1235793027 | James Dostert | Counselor | 1601 E 4th Blvd. Bldg. 17, Ste A212, Vancouver, WA 98661 | 2019-04-26 |
| 1306305289 | Kathryn Susanne Scott | Social Worker | Attn: Kathryn Scott, V3cnh, 1601 E. Fourth Plain Blvd., Vancouver, WA 98661 | 2019-03-19 |
| 1952860637 | Alice Rogers | Occupational Therapist | Vancouver Public Schools, 2901 Falk Rd., Vancouver, WA 98661 | 2019-03-13 |
| 1053878538 | Paula Moore | Counselor | 9626 Ne Fourth Plain Blvd, Vancouver, WA 98661 | 2019-02-21 |
| 1558825729 | Cassandra Marie Nichols | Counselor | 1601 E 4th Blvd, Vancouver, WA 98661 | 2019-01-22 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
| 1023505229 | Ellen Barbour | Counselor | 1601 E 4th Plain Blvd Bldg. 17, Ste A212, Vancouver, WA 98661 | 2018-04-13 |
| 1679096325 | Brian Scott Coleman | Counselor | 1601 East Fourth Plain Blvd., Bldg #17, Ste. A212, Vancouver, WA 98661 | 2017-07-24 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366067803 | Darcy Jacquet | Counselor | 7708 Ne 78th St, Vancouver, WA 98662-3603 | 2020-06-10 |
| 1942832381 | Dena M Alt | Counselor | 8000 Ne 139th Ave, Vancouver, WA 98682-3337 | 2020-02-04 |
| 1669019659 | Heather Alexandra Smith | Counselor | 6221 Ne Fourth Plain Blvd, Suite 130, Vancouver, WA 98661-7210 | 2019-12-09 |
| 1790327807 | Ly Khim | Counselor | 1601 E 4th Plain Blvd Bldg 17m, Vancouver, WA 98661-3717 | 2019-10-09 |
| 1922665090 | Lindsey Beth Lapore | Counselor | 6221 Ne Fourth Plain Blvd Apt 120, Vancouver, WA 98661-7210 | 2019-05-23 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1629549878 | Christine M Kille | Counselor | 4107 Nw Fruit Valley Rd Ste J, Vancouver, WA 98660-1275 | 2018-12-16 |
| 1356847008 | Brotherhood of The Broken | Counselor | 5411 Ne 107th Ave Ste 101, Vancouver, WA 98662-6347 | 2018-04-02 |
| 1174047690 | Douglas Gangat Uy | Counselor | 1610 C Street, Suite 102, Vancouver, WA 98663 | 2017-07-26 |
| 1477075091 | Justin Scott Schultz | Counselor | 1601 E 4th Plain Blvd # A212, Vancouver, WA 98661-3713 | 2017-07-14 |
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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.