DR. ADAM SPACH WILSON (NPI# 1790745933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790745933 |
| Entity Type | Individual |
| Full Name | DR. ADAM SPACH WILSON |
| Credential | M.D. |
| Practice Address |
1405 Se 164th Ave Ste 102 Vancouver WA 98683-9644 |
| Practice Telephone | 3602564425 |
| Practice Fax Number | 3602541844 |
| Mailing Telephone | 3602564425 |
| Mailing Fax Number | 3602541844 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | MD00034230 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WA DEPT OF LABOR & INDUST | 0130871 | 01 |
| OR | REGENCE HMOO | 300151208 | 01 |
| OR | REGENCE BLUE CROSS OF OR | 011826007 | 01 |
| WA | TRIWEST | 98683A007 | 01 |
| WA | 8197287 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659913531 | Adam A Wilson | Nurse Practitioner | 132 Moultrie Crossing Ln, St Augustine, FL 32086-5242 | 2019-10-12 |
| 1255749537 | Adam Wilson | Pharmacist | 1250 Bridalwood Loop, Lehi, UT 84043-4908 | 2014-07-30 |
| 1467695072 | Adam S Wilson | Orthopaedic Surgery | 940 Central Park Dr Ste 280, Steamboat Springs, CO 80487-8853 | 2009-04-13 |
| 1184757148 | Adam Christopher Wilson | Counselor | 6399 S Santa Fe Dr, Littleton, CO 80120-2912 | 2007-03-13 |
| 1518494012 | Adam Wilson | Behavior Technician | 73 White Bridge Rd Ste 103-232, Nashville, TN 37205-1444 | 2017-05-15 |
| 1790150449 | Adam Wilson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2015-12-07 |
| 1275925547 | Adam J Wilson | Nurse Practitioner | 1401 Harrodsburg Rd, A300, Lexington, KY 40504-3751 | 2015-02-24 |
| 1639597875 | Adam Wilson | Family Medicine | 4500 N Shallowford Rd Ste B, Atlanta, GA 30338-6476 | 2014-04-04 |
| 1528309945 | Adam K Wilson | Registered Nurse | 2011 Murphy Ave, Suite 301, Nashville, TN 37203-2023 | 2013-03-11 |
| 1518114800 | Adam Richard Wilson | Physician Assistant | 2375 Summit Park Dr, Petoskey, MI 49770-8685 | 2008-08-19 |
| Street Address |
1405 SE 164TH AVE STE 102 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98683-9644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598850455 | Joseph Goyzman | Audiologist | 1405 Se 164th Ave Ste 102, Vancouver, WA 98683-9644 | 2006-10-04 |
| 1265527162 | Vancouver Ent and Ent of The Northwest Pllc | Clinic/Center | 1405 Se 164th Ave Ste 102, Vancouver, WA 98683-9644 | 2006-10-04 |
| 1861587891 | Bradly J Edgerton | Audiologist | 1405 Se 164th Ave Ste 102, Vancouver, WA 98683-9644 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761222 | Nathaniel James Eugene Powell | Behavior Technician | 4101se 192nd Ave, Ste 101, Vancouver, WA 98683 | 2020-02-07 |
| 1295294973 | Ubmhc1, LLC | Clinical Medical Laboratory | 18110 Southeast 34th St, Building 2, Suite 240, Vancouver, WA 98683 | 2019-03-13 |
| 1982116695 | Amy K Adams | Massage Therapist | 2716 Se 169th Ave, X-232, Vancouver, WA 98683 | 2017-11-03 |
| 1477088920 | Alexandra Ransonet | Dental Hygienist | 19111 Se 34th. St., Vancouver, WA 98683 | 2017-04-21 |
| 1639618630 | Digestive Gi Care | Internal Medicine | 305 Sw Chkalov Dr, 111-140, Vancouver, WA 98683 | 2017-02-23 |
| 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 |
| Find all providers in zip 98683 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437262094 | Sande Bartels Irwin | Otolaryngology | 203 Se Park Plaza Dr, Suite 140, Vancouver, WA 98684-5886 | 2006-08-17 |
| 1609836840 | Philemon Lynn Anderson | Otolaryngology | 718 Ne 87th Ave Ste 100, Vancouver, WA 98664-1970 | 2006-03-23 |
| 1215996038 | David Charles Bloom | Otolaryngology | 2121 Ne 139th Street, Suite 245, Vancouver, WA 98686 | 2006-03-21 |
| 1740660638 | Christoph Michael Prummer | Otolaryngology | 2525 Ne 139th St Ste 220, Vancouver, WA 98686-2719 | 2015-06-04 |
| 1982857298 | Kate Elizabeth Mccarn | Otolaryngology | 501 Se 172nd Ave, Vancouver, WA 98684-9542 | 2008-10-30 |
| 1932316734 | Kelvin A Lindgren | Otolaryngology | 3506 Main St, Vancouver, WA 98663-2224 | 2007-05-17 |
| 1407077712 | Mark John Furin | Otolaryngology | 2525 Ne 139th St, Suite 220, Vancouver, WA 98686-2719 | 2007-05-02 |
| 1992851455 | Jonathan Edward Zwart | Otolaryngology | 2525 Ne 139th St, Vancouver, WA 98686-2719 | 2007-01-26 |
| 1417042730 | Michael J. Mitchell | Otolaryngology | 1405 Se 164th Ave, Suite 102, Vancouver, WA 98683-9644 | 2006-10-03 |
| 1972528164 | Yu-fang Nancy Liu | Otolaryngology | 700 Ne 87th Ave, Vancouver, WA 98664-1913 | 2006-07-12 |
| 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.