Active NPI
Geoffrey Severin Wampach, BS
- Counselor
- Vancouver, WA
National Provider Identifier
1104439686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 61584335
- Practice address
- 1313 NE 134TH St Ste 220a
Vancouver, WA 98685-2722 - Phone
- (360) 356-0060
- NPI assigned
- Aug 25, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 61584335 | WA | Primary |
Addresses
Primary practice location
1313 NE 134TH St Ste 220a
Vancouver, WA 98685-2722
Mailing address
2919 NE 116TH Ave
Vancouver, WA 98682-8720
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61584335 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1104439686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2919 NE 116TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986828720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 NE 134TH ST STE 220A",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986852722",
"telephone_number": "360-356-0060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAMPACH",
"first_name": "GEOFFREY",
"middle_name": "SEVERIN",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-25",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "61584335",
"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 Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.