Individual provider Active NPI

Jordan Graybill, M.D.

  • Interventional Pain Medicine Physician
  • Vancouver, WA
National Provider Identifier
1053585802
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD60544409 Issued in WA
Practice address
222 NE Park Plaza Dr Ste 110
Vancouver, WA 98684-5896
Phone
(360) 314-2548
Fax
(360) 799-4634
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X MD60544409 WA Primary

Addresses

Primary practice location

222 NE Park Plaza Dr Ste 110
Vancouver, WA 98684-5896

Mailing address

222 NE Park Plaza Dr Ste 110
Vancouver, WA 98684-5896
Phone (360) 314-2548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714002721 WA Practitioner - AnesthesiologyPractitioner - Pain Management 2860640315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Loma Linda University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 NE Park Plaza Dr
Suite 110
Vancouver, WA 98684-5896
Phone (360) 314-2548

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60544409WAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cure Pain Management, PLLC Pain Medicine CurrentSince Oct 1, 2017 Accepting new patients

Locations

19215 SE 34th St
Ste 106415
Camas, WA 98607

920 NE 112th Ave
Ste 104
Vancouver, WA 98684
Phone (360) 314-2548

222 NE Park Plaza Dr
Ste 110
Vancouver, WA 98684
Phone (360) 314-2548

Interoperability endpoints

  • Direct secure messaging: jgraybill@direct.meditouchehr.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1053585802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 NE PARK PLAZA DR STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845896",
            "telephone_number": "360-314-2548",
            "fax_number": "360-799-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 NE PARK PLAZA DR STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845896",
            "telephone_number": "360-314-2548",
            "fax_number": "360-799-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYBILL",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "MD60544409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.