ERIC DONALD OTTENBACHER (NPI# 1952308967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952308967 |
| Entity Type | Individual |
| Full Name | ERIC DONALD OTTENBACHER |
| Credential | PA |
| Practice Address |
1615 Delaware St Longview WA 98632-2310 |
| Mailing Address |
Po Box 249 Longview WA 98632-7154 |
| Practice Telephone | 3604142385 |
| Practice Fax Number | 3604142386 |
| Mailing Telephone | 3604142048 |
| Mailing Fax Number | 3605756749 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA10004156 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8330938 | 05 | |
| WA | LABOR & IND. | 149048 | 01 |
| WA | CRIME VICTIMS | 8929945 | 01 |
| Street Address |
1615 DELAWARE ST |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1073083903 | Ashley Briana-marie Gentry | Physician Assistant | 707 Hollybrook Dr # 200, Longview, TX 75605-2410 | 2018-12-04 |
| 1275637472 | Roderick Kelly | Physician Assistant | 1509 W Loop 281, Suite 2-b, Longview, TX 75604-2820 | 2006-09-11 |
| 1093751265 | Michael L. Smith | Physician Assistant | 2010 Bill Owens Pkwy, Longview, TX 75604-6210 | 2006-06-22 |
| 1174501811 | Denis Adams | Physician Assistant | 901 Walnut Hill Dr, Longview, TX 75605-5054 | 2006-01-04 |
| 1336123462 | Britta C Fischer | Physician Assistant | 783 Commerce Ave Ste 300, Longview, WA 98632-2495 | 2005-12-01 |
| 1265421499 | George Francis Zerucha | Physician Assistant | 121 Oak Isle Dr, Longview, TX 75605-7523 | 2005-10-20 |
| 1063412468 | Amy J Stacey | Physician Assistant | 1300 N 4th St, Longview, TX 75601-4717 | 2005-07-28 |
| 1407855455 | Debbi Spitler | Physician Assistant | 921 14th Ave, Longview, WA 98632-2316 | 2005-07-20 |
| 1043217664 | David L Oliver | Physician Assistant | 1706 Washington Way, Longview, WA 98632-2952 | 2005-06-29 |
| Find all providers in LONGVIEW | ||||
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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.