MRS. LISA D ZYLSTRA (NPI# 1821142738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821142738 |
| Entity Type | Individual |
| Full Name | MRS. LISA D ZYLSTRA |
| Other Name | LISA M DEKKER |
| Credential | PA-C |
| Practice Address |
1405 Se 164th Ave Suite 101 Vancouver WA 98683-9644 |
| Mailing Address |
Po Box 832 412 N Simons St Ridgefield WA 98642-0832 |
| Practice Telephone | 3602537666 |
| Practice Fax Number | 3602536792 |
| Mailing Telephone | 3608872210 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004703 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1405 SE 164TH AVE SUITE 101 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98683-9644 |
| 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 |
| 1558552380 | 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 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982058814 | Nw Interventional Medicine and Orthopedic Rehab Pllc | Physician Assistant | 11802 Ne 65th St., Vancouver, WA 98662 | 2016-04-18 |
| 1194128116 | Kimberlee Tess | Physician Assistant | 13003 Ne 46th St, Vancouver, WA 98682-6465 | 2014-10-04 |
| 1689977852 | Maliheh Razavi | Physician Assistant | 14508 Nw 20th Ave Ste 102, Vancouver, WA 98685 | 2010-12-10 |
| 1093936122 | Dan Lee Osborne | Physician Assistant | 4421 Ne St. Johns Blvd, Suite F, Vancouver, WA 98661-2573 | 2007-05-02 |
| 1629158464 | Joseph No Middle Name Marzucco | Physician Assistant | 406 Se 131st Ave Ste 101, Vancouver, WA 98683-4031 | 2006-10-16 |
| 1124571971 | Rebecca Rowney | Physician Assistant | 2525 Ne 139th St, Vancouver, WA 98686-2719 | 2016-07-28 |
| 1750751285 | Rolando Mendez | Physician Assistant | 100 E 33rd St, Suite 100, Vancouver, WA 98663-2776 | 2015-09-26 |
| 1356734966 | Jeffery Smith | Physician Assistant | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2015-03-07 |
| 1447640347 | Vancouver Chiropractic Group | Physician Assistant | 16821 Se Mcgillivray Blvd, Suite 204, Vancouver, WA 98683-0499 | 2015-01-29 |
| 1689077059 | Aaron Fordice | Physician Assistant | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2014-09-30 |
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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.