Active NPI
Tina Marie House, L.M.P
- Contractor
- Vancouver, WA
National Provider Identifier
1073712170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MA00023564
- Practice address
- 109 SE 101St Ave
Vancouver, WA 98664-3907 - Phone
- (360) 256-6748
- NPI assigned
- Jul 17, 2007
- Last updated
- Jul 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | MA00023564 | WA | Primary |
Addresses
Primary practice location
109 SE 101St Ave
Vancouver, WA 98664-3907
Mailing address
PO Box 544
Forest Grove, OR 97116-0544
Phone (360) 773-3347
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00023564 | WA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1073712170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 544",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971160544",
"telephone_number": "360-773-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 SE 101ST AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986643907",
"telephone_number": "360-256-6748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSE",
"first_name": "TINA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "L.M.P",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-17",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "MA00023564",
"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 Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.