Active NPI
Andrea Cobb, MA
- Other Technician
- Vancouver, WA
National Provider Identifier
1013141837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- MA00022567
- Practice address
- 12306 SE Mill Plain Blvd
Vancouver, WA 98684-6061 - Phone
- (360) 604-5982
- Fax
- (360) 604-5983
- NPI assigned
- May 7, 2009
- Last updated
- May 7, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | MA00022567 | WA | Primary |
Addresses
Primary practice location
12306 SE Mill Plain Blvd
Vancouver, WA 98684-6061
Mailing address
12306 SE Mill Plain Blvd
Vancouver, WA 98684-6061
Phone (360) 604-5982
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891465001 | Other | OR | BLUE CROSS BLUE SHIELD OF OREGON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00022567 | WA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1013141837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12306 SE MILL PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986846061",
"telephone_number": "360-604-5982",
"fax_number": "360-604-5983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12306 SE MILL PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986846061",
"telephone_number": "360-604-5982",
"fax_number": "360-604-5983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "ANDREA",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-07",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WA",
"license": "MA00022567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF OREGON",
"identifier": "891465001",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.