MR. WAYNE H SHEPARD (NPI# 1871699017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871699017 |
| Entity Type | Individual |
| Full Name | MR. WAYNE H SHEPARD |
| Practice Address |
12607 Se Mill Plain Blvd Cascade Park Medical Office Vancouver WA 98684-6055 |
| Mailing Address |
23414 Ne 139th Loop Brush Prairie WA 98606-9624 |
| Practice Telephone | 3604186001 |
| Mailing Telephone | 3608965153 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
DO00001507 | WA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376653154 | Wayne Kent Shepard | Dentist | 4201 Torrance Blvd, Suite 450, Torrance, CA 90503-4504 | 2006-08-30 |
| Street Address |
12607 SE MILL PLAIN BLVD CASCADE PARK MEDICAL OFFICE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-6055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659340735 | Richard M Shuey | Psychiatry & Neurology | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2006-03-14 |
| 1447883020 | Kendra M Latimer | Case Manager/Care Coordinator | 12607 Se Mill Plain Blvd, Vancouver, WA 98684 | 2020-02-21 |
| 1285273086 | Leayn N Vandeven | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-12-27 |
| 1528605342 | Jeff Cooksey | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-12-01 |
| 1104461961 | Fidel Hernandez Jr. | Nurse Practitioner | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-11-15 |
| 1518516822 | Tameca Vernee Pryce | Respiratory Therapist, Certified | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-09-09 |
| 1700348042 | Beredu Abraham Geleto | Registered Nurse | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2019-04-04 |
| 1942772660 | Patricia Maria Rivera | Psychologist | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-12-19 |
| 1992288328 | Irene Moulton | Pharmacist | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-09-12 |
| 1962982348 | Christina Kirkpatrick | Student in an Organized Health Care Education/Training Program | 12607 Se Mill Plain Blvd, Vancouver, WA 98684-6055 | 2018-08-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
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| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588143986 | Robin Nordlum | Technician/Technologist | 814 Ne 123rd Ave, Vancouver, WA 98684-5842 | 2018-08-07 |
| 1457591265 | America's Best Contacts & Eyeglasses | Technician/Technologist | 9301 Ne 5th Ave Ste 114, Vancouver, WA 98665-8271 | 2009-03-06 |
| 1588831754 | Luke Huy-viet Pham | Technician/Technologist | 5305 Ne 121st Ave Ste N501, Vancouver, WA 98682-6202 | 2008-05-15 |
| 1114194990 | Randall Mark Miller | Technician/Technologist | 1221 Se Ellsworth Rd, Apt Q183, Vancouver, WA 98664-6299 | 2008-05-12 |
| 1841392545 | Deanna Kay Curtis | Technician/Technologist | 905 Se 136th Ave Apt V8, Vancouver, WA 98683-3526 | 2006-09-02 |
| 1821474032 | Wal-mart Stores, Inc. | Technician/Technologist | 14505 Ne Fourth Plain Blvd, Vancouver, WA 98682-5003 | 2015-08-11 |
| 1265856934 | America's Best Contacts & Eyeglasses | Technician/Technologist | 8101 Ne Parkway Dr, Vancouver, WA 98662-7911 | 2014-02-14 |
| 1689888950 | Corinna Gae Frikken | Technician/Technologist | 14406 Ne 20th Ave, Vancouver, WA 98686-1448 | 2007-05-09 |
| 1427134618 | Wal-mart Stores, Inc | Technician/Technologist | 221 Ne 104th Ave, Vancouver, WA 98664-4505 | 2006-10-31 |
| 1154402584 | Wal-mart Stores, Inc | Technician/Technologist | 430 Se 192nd Ave, Vancouver, WA 98683-9531 | 2006-10-19 |
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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.