PNW Aging Specialty Services, LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

PNW AGING SPECIALTY SERVICES, LLC

Doing business as

PNW Aging

Practice address

7720 NE Vancouver Mall Dr Ste 110
Vancouver, WA 98662-7918

Phone

(360) 883-3569

Fax

(360) 883-3568

NPI assigned

Aug 18, 2022

Organization subpart

No

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

Authorized official

Name

Joseph Yourchek, CNA

Title

Owner/Administrator

Phone

(503) 488-0318

Specialties & licenses 1

Addresses

Other names 1

• PNW Aging Doing business as

Locations

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1104544881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 NE VANCOUVER MALL DR STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986627918",
            "telephone_number": "360-883-3569",
            "fax_number": "360-883-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 NE VANCOUVER MALL DR STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986627918",
            "telephone_number": "360-883-3569",
            "fax_number": "360-883-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNW AGING SPECIALTY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "YOURCHEK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "503-488-0318",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNW Aging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Aide in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Home Health Aide in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.