MR. BENAJMIN HUCKETT (NPI# 1831583863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831583863 |
| Entity Type | Individual |
| Full Name | MR. BENAJMIN HUCKETT |
| Credential | FNP |
| Practice Address |
6100 Ne Fourth Plain Blvd Vancouver WA 98661-6830 |
| Mailing Address |
Po Box 34703 Seattle WA 98124-1703 |
| Practice Telephone | 3609472550 |
| Practice Fax Number | 3609472533 |
| Mailing Telephone | 2064742001 |
| Mailing Fax Number | 2067648005 |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201501609NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 426 Sw Stark St Fl 9, Portland, OR 972042303 | 5039885958 |
| Street Address |
6100 NE FOURTH PLAIN BLVD |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98661-6830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230028 | Kathryn Ann Willits | Nurse Practitioner | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2005-07-22 |
| 1447880737 | Scott G Henke | Counselor | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2020-01-25 |
| 1871961680 | Sea-mar Community Health Center | Family Medicine | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2015-09-10 |
| 1275925372 | Keely Vrsalovich | Nurse Practitioner | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2015-02-26 |
| 1871788711 | Diana Charese Corson | Advanced Practice Midwife | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2007-09-13 |
| 1154346526 | Kay Campbell | Advanced Practice Midwife | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2006-07-13 |
| 1770508152 | Karin Misao Ide | Nurse Practitioner | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2006-07-13 |
| 1568487932 | Lenorah Rae Cottrell | Nurse Practitioner | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2006-07-13 |
| 1750314365 | Jean M Maunder | Advanced Practice Midwife | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2006-07-08 |
| 1073546685 | Susan M Firman | Advanced Practice Midwife | 6100 Ne Fourth Plain Blvd, Vancouver, WA 98661-6830 | 2006-07-08 |
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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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942711767 | Julie B Lawrence | Nurse Practitioner | 900 Ne 139th Street, Suite 202, Vancouver, WA 98685 | 2017-10-19 |
| 1588174833 | Oliver Uy | Nurse Practitioner | 15814 Ne 72nd, Vancouver, WA 98682 | 2017-10-01 |
| 1780103549 | Rebecca Adele Rutledge | Nurse Practitioner | 10503 Ne 67th Ave, Vancouver, WA 98686-5103 | 2017-09-13 |
| 1689044182 | Moonstone Medical Group, Pllc | Nurse Practitioner | 9320 Ne Vancouver Mall Dr, Suite 103, Vancouver, WA 98662-8203 | 2015-09-28 |
| 1366821993 | Derek Simmons | Nurse Practitioner | 700 Ne 87th Ave # 260, Vancouver, WA 98664-1913 | 2015-05-28 |
| 1306155270 | Christie Anne Kratovil | Nurse Practitioner | 8614 E Mill Plain Blvd Ste 310, Vancouver, WA 98664-2058 | 2010-09-27 |
| 1780822916 | Stephanie Renee Jones | Nurse Practitioner | 406 Se 131st Ave Ste 203, Vancouver, WA 98683-4013 | 2009-01-26 |
| 1942484308 | Chrissie Collette Russell-wilson | Nurse Practitioner | 501 Se 172nd Ave Ste 130, Vancouver, WA 98684 | 2007-12-20 |
| 1093831752 | Sherrie Lee Thomas | Nurse Practitioner | Cascade Park Medical Office. 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2007-03-22 |
| 1669575692 | Debra Ann Goldstein | Nurse Practitioner | 12607 S.e. Mill Plain Blvd., Vancouver, WA 98684 | 2006-09-06 |
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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.