Active NPI
Debbie C. Anderson, ARNP
- Family Nurse Practitioner
- Longview, WA
National Provider Identifier
1104823699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30005930
- Practice address
- 748 14TH Ave
Longview, WA 98632-2315 - Phone
- (360) 501-3601
- Fax
- (360) 501-3648
- NPI assigned
- Jun 30, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00119013 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP30005930 | WA | Primary |
Addresses
Primary practice location
748 14TH Ave
Longview, WA 98632-2315
Mailing address
PO Box 249
Longview, WA 98632-7154
Phone (360) 414-2000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9642646 | Medicaid | WA | |
| 0190597 | Other | WA | LABOR & IND. |
| 8939247 | Other | WA | CRIME VICTIMS |
| 231477 | Medicaid | OR | |
| P00158068 | Other | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00119013 | WA | MD | Registered Nurse |
| AP30005930 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1104823699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 249",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986327154",
"telephone_number": "360-414-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "748 14TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322315",
"telephone_number": "360-501-3601",
"fax_number": "360-501-3648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DEBBIE",
"middle_name": "C.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-30",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00119013",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30005930",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9642646",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & IND.",
"identifier": "0190597",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8939247",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "231477",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00158068",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.