Urology Northwest, PS

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGY NORTHWEST, PS

Practice address

3100 Tongass Ave
3Rd Floor Visiting Clinic
Ketchikan, AK 99901-5746

Phone

(855) 881-5319

NPI assigned

Oct 23, 2012

Organization subpart

Yes

Parent organization

UROLOGY NORTHWEST, PSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Candy Shalon Chapman

Title

Administrator

Phone

(425) 275-5547

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Urology Northwest, PS AK Other name

Part of

Karny Jacoby MD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1003169434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 244TH ST SW",
            "address_2": "111",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435400",
            "telephone_number": "425-275-5547",
            "fax_number": "425-275-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TONGASS AVE",
            "address_2": "3RD FLOOR VISITING CLINIC",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015746",
            "telephone_number": "855-881-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY NORTHWEST, PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UROLOGY NORTHWEST, PS",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "CANDY",
        "authorized_official_middle_name": "SHALON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "425-275-5547"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MPG0374",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology Northwest, PS AK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lindsay Tucker, CCC-SLP
• Phillip J Tucker
• Velia Inez Turknett, RN
• U.S. Coast Guard Medical Clinic
• Keriann Uno, CNM, APRN
• US Coast Guard Finance Center (Ketchikan Uscg Phcy)
• Ashlee Vannostrand
• Danny Vannostrand
• John E. Varallo, MD, MPH
• Melanie Vasquez

• Urology Physician in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Urology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.