Individual provider Active NPI

Miso Bak, NP

  • Adult Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1033015391
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG06260149 Issued in WA
Practice address
14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone
(360) 487-1000
NPI assigned
Oct 14, 2026
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG06260149 WA Primary

Addresses

Primary practice location

14406 NE 20TH Ave
Vancouver, WA 98686-1448

Mailing address

1110 NE 115TH St
Vancouver, WA 98685-4049
Phone (307) 220-7168

Other practice location 1

10060 NE Evergreen Pkwy
Hillsboro, OR 97124-6448
Phone (800) 813-2000

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

NPI Registry JSON

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1033015391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 NE 115TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854049",
            "telephone_number": "307-220-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "360-487-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10060 NE Evergreen Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971246448",
            "country_code": "US",
            "telephone_number": "800-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAK",
        "first_name": "MISO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AG06260149",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 16, 2026; 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.