GEROMEDICAL PSYCHOLOGICAL SERVICE PS (NPI# 1659482925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659482925 |
| Entity Type | Organization |
| Organization Name | GEROMEDICAL PSYCHOLOGICAL SERVICE PS |
| Practice Address |
2400 Main St Vancouver WA 98660-2663 |
| Practice Telephone | 3605749565 |
| Practice Fax Number | 3605749685 |
| Mailing Telephone | 3605749565 |
| Mailing Fax Number | 3605749685 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | DR. DERICK A SCOVEL (V. PRESIDENT) |
| Authorized Official Telephone | 3605749565 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY2484 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7127087 | 05 | |
| WA | RR MEDICARE | DD6273 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10000 Ne 7th Ave, Ste 215, Vancouver, WA 986854542 | 3605749565 | 3605749685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043501836 | Geromedical Psychological Service Ps | Psychologist | 3550 Sw Bond Ave, Portland, OR 97239-4507 | 2011-04-27 |
| Street Address |
2400 MAIN ST |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98660-2663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093817991 | Elizabeth A Sawyer Scovel | Psychologist | 2400 Main St, Vancouver, WA 98660-2663 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538779137 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 781 W Columbia Way, Vancouver, WA 98660 | 2020-08-07 |
| 1538641527 | Melissa Molly Sivaram | Counselor | 1012 Esther St, Vancouver, WA 98660 | 2018-09-05 |
| 1679082598 | Christopher Lewis Schwab | Peer Specialist | 5197 Nw Lower River Rd, Vancouver, WA 98660 | 2017-09-22 |
| 1023560141 | Disabled Veterans Hawaii LLC | Durable Medical Equipment & Medical Supplies | 4817 Nw Fruit Valley Road, Suite 100, Vancouver, WA 98660 | 2016-10-25 |
| 1023493004 | Laura Nicole Wood | Counselor | 1104 Main St Ste M100, Vancouver, WA 98660 | 2015-07-20 |
| 1790034627 | Clark County Juvenile Court | Marriage & Family Therapist | 500 W 11th Street, Vancouver, WA 98660 | 2012-09-06 |
| 1538439104 | Hutton Chiropractic Clinic Inc | Chiropractor | 703 Broadway Street, Ste 650, Vancouver, WA 98660 | 2012-01-12 |
| 1134422629 | Brenda Marie Bible | Social Worker | 101 E 8th St Ste 110, Vancouver, WA 98660 | 2010-12-06 |
| 1871895409 | Donna L Benedicktus | Contractor | 210 E Evergreen Blvd, Vancouver, WA 98660 | 2010-12-02 |
| 1992007801 | Peter Ray Hasemeier | Massage Therapist | 805 Broadway St., Vancouver, WA 98660 | 2010-11-29 |
| Find all providers in zip 98660 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265055172 | Dani Nierenberg Phd Bcb Pllc | Psychologist | 108 Se 124th Ave Ste 12, Vancouver, WA 98684-6015 | 2020-05-27 |
| 1790311157 | Ryan Mangum | Psychologist | 2009 F St, Vancouver, WA 98663-3345 | 2020-03-18 |
| 1790217578 | Allison Rose Chambers-dixson | Psychologist | 750 Officers Row, Vancouver, WA 98661-3845 | 2017-03-30 |
| 1225408941 | Peter Weiss | Psychologist | 237 Ne Chkalov Dr Ste 118, Vancouver, WA 98684-5054 | 2015-10-07 |
| 1912281254 | Linda Lee | Psychologist | 13220 Nw 33rd Ave, Vancouver, WA 98685-2288 | 2011-10-05 |
| 1215241781 | Chrystal Joy Agnor | Psychologist | 10708 Ne 90th Ct, Vancouver, WA 98662-1455 | 2010-07-27 |
| 1093040743 | Gregory Allen May | Psychologist | 400 E Evergreen Blvd Ste 209, Vancouver, WA 98660-3264 | 2009-10-14 |
| 1780826289 | Kelly Ross Fielding | Psychologist | 201 E 19th St, Vancouver, WA 98663-3301 | 2009-03-30 |
| 1174764732 | Cecilia M Dominguez | Psychologist | 2101 Ne 139th St Ste 265, Vancouver, WA 98686-2311 | 2009-03-11 |
| 1265684765 | Gary Seeman | Psychologist | 9901 Ne 7th Ave Ste B231, Vancouver, WA 98685-4538 | 2008-10-15 |
| 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.