MS. LISA MARIE HOLLER (NPI# 1962869487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962869487 |
| Entity Type | Individual |
| Full Name | MS. LISA MARIE HOLLER |
| Credential | ANP |
| Practice Address |
2121 Ne 139th St Ste 360 Vancouver WA 98686-2316 |
| Mailing Address |
1650 Nw Naito Pkwy Ste 185 Portland OR 97209-2535 |
| Practice Telephone | 3602130085 |
| Practice Fax Number | 3602130049 |
| Mailing Telephone | 9719835260 |
| Mailing Fax Number | 9719835326 |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP60650386 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
201600394NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2058463 | 05 | |
| OR | 500708724 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 19260 Sw 65th Ave Ste 420, Tualatin, OR 970625712 | 5036920405 | 5036927978 |
| 2222 Nw Lovejoy St Ste 606, Portland, OR 972105104 | 5032297554 | 5032745400 |
| 24900 Se Stark St Ste 103, Gresham, OR 970303381 | 5039071101 | 5039070177 |
| 500 N Columbia River Hwy, Saint Helens, OR 970511299 | 5032297554 | 5032484666 |
| Street Address |
2121 NE 139TH ST STE 360 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98686-2316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538120969 | Ajay Tripuraneni | Internal Medicine | 2121 Ne 139th St Ste 360, Vancouver, WA 98686-2316 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891117 | Dorota Bozena Barton | Speech-Language Pathologist | 2121 Ne 139th Street Mob A, Suite 200, Vancouver, WA 98686 | 2018-12-03 |
| 1881161818 | Michelle Wolfe | Dental Assistant | A101, 1484, 14313 Ne 20th Ave, Vancouver, WA 98686 | 2018-10-29 |
| 1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
| 1801382387 | Kristopher K Kostenko | Dentist | 14201 Ne 20th Ave Ste A101, Vancouver, WA 98686 | 2018-07-08 |
| 1689164071 | Tegan Mills | Occupational Therapist | 7101 Ne 109th Street, Apt 64, Vancouver, WA 98686 | 2018-05-11 |
| 1164924122 | Kate Kristin Lawrence | Speech-Language Pathologist | 2215 Ne 104th St, Vancouver, WA 98686 | 2018-03-06 |
| 1437609567 | Elina Baranets | Registered Nurse | 14204 Ne Salmon Creek Avenue, Vancouver, WA 98686 | 2016-10-13 |
| 1386039550 | Sean Vikram Bhatia | Internal Medicine | Kaiser Salmon Creek, 14406 Ne 20th Ave, Vancouver, WA 98686 | 2015-04-03 |
| 1376988642 | Lindsay Hussey-andersen | Orthopaedic Surgery | 2525 Ne 139th St Ste 140, Vancouver, WA 98686 | 2013-05-01 |
| 1710253109 | Legacy Salmon Creek Hospital | Speech-Language Pathologist | 2121 Ne 139th St., Mob A, Ste 200, Vancouver, WA 98686 | 2012-03-29 |
| Find all providers in zip 98686 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316218779 | Christie Joyce Podhora | Nurse Practitioner | 800 Ne 136th Ave, Ste 220, Vancouver, WA 98684-6933 | 2012-01-17 |
| 1174952139 | Jill E Faccia | Nurse Practitioner | 700 Ne 87th Ave, Vancouver, WA 98664 | 2013-11-10 |
| 1992144208 | Ross Puterbaugh | Nurse Practitioner | 2101 Ne 139th St, Suite 460, Vancouver, WA 98686-2309 | 2013-06-19 |
| 1689833766 | Pamela Dunnick | Nurse Practitioner | 2811 Ne 139th St, Vancouver, WA 98686-2724 | 2008-06-04 |
| 1508042102 | Pamela Suzanne Bruhn | Nurse Practitioner | 420 Ne Mother Joseph Place, Vancouver, WA 98664 | 2008-01-14 |
| 1740404565 | Rodie Adeline Renn-lasher | Nurse Practitioner | 221 Ne 104th Ave, Suite 106, Vancouver, WA 98664-4505 | 2007-04-12 |
| 1154334639 | Jolene Pyle | Nurse Practitioner | 2211 E Mill Plain Blvd, Vancouver, WA 98661-4329 | 2006-08-14 |
| 1316957236 | Lottie I Sharp-york | Nurse Practitioner | 1601 E Fourth Plain Blvd, Vancouver, WA 98661-3753 | 2006-08-09 |
| 1720014228 | Kimberley Ann Everett | Nurse Practitioner | 700 Ne 87th Ave, Vancouver, WA 98664-1913 | 2006-06-25 |
| 1477509990 | Marion Cluzel | Nurse Practitioner | 700 Ne 87th Ave, Vancouver, WA 98664 | 2006-05-26 |
| 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.