DR. TREVOR D. TREDENNICK (NPI# 1649264052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649264052 |
| Entity Type | Individual |
| Full Name | DR. TREVOR D. TREDENNICK |
| Credential | M.D. |
| Practice Address |
1615 Delaware St Direct To Emergency Department Longview WA 98632-2310 |
| Practice Telephone | 3606364818 |
| Practice Fax Number | 3606364976 |
| Mailing Telephone | 3606364818 |
| Mailing Fax Number | 3606364976 |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036-112632 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8420713 | 05 | |
| IL | 036-112632 | 05 |
| Street Address |
1615 DELAWARE ST DIRECT TO EMERGENCY DEPARTMENT |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083150973 | Medstop Clinic | Emergency Medicine | 2393 H G Mosley Pkwy, Building 4 Ste 101, Longview, TX 75604-3665 | 2017-01-16 |
| 1720421878 | Drew David Gibson | Emergency Medicine | 700 E. Marshall Ave, Good Shepherd Medical Center, Longview, TX 75601-4000 | 2013-04-08 |
| 1104037639 | Jeffrey G Mcwilliams Sr. | Emergency Medicine | 112 Oak Isle, Longview, TX 75605 | 2007-05-25 |
| 1548390362 | Regional Ep Associates Pllc | Emergency Medicine | 2901 N Fourth St, Longview, TX 75606-5128 | 2007-03-07 |
| 1447296975 | Gerald J Akpassa | Emergency Medicine | 1029 Riverwood Dr, Longview, TX 75604-6228 | 2006-06-22 |
| 1346201910 | Eunice Webb | Emergency Medicine | 106 Northhill Ct, Longview, TX 75605-2054 | 2006-03-31 |
| 1205814993 | Timothy Frank Archer | Emergency Medicine | 3111 Mccann Rd, Emergency Room, Longview, TX 75605 | 2006-01-04 |
| 1992781090 | Sanford Watkins | Emergency Medicine | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2005-12-20 |
| 1679562615 | Sidney L Redels | Emergency Medicine | 1761 W Loop 281, Longview, TX 75604-2734 | 2005-10-20 |
| 1215561998 | Pacific Northwest Urgent Care LLC | Emergency Medicine | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632-4171 | 2020-03-02 |
| Find all providers in LONGVIEW | ||||
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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.