Individual provider Active NPI

Judith A Pollock, RN

  • Registered Nurse
  • Vancouver, WA
National Provider Identifier
1104984434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00145585 Issued in WA
Practice address
6926 NE Fourth Plain Blvd
Vancouver, WA 98661
Phone
(360) 993-3000
Fax
(360) 993-3047
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00145585 WA Primary

Addresses

Primary practice location

6926 NE Fourth Plain Blvd
Vancouver, WA 98661

Mailing address

PO Box 1337
Vancouver, WA 98666-1337
Phone (360) 993-3000

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00145585WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104984434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986661337",
            "telephone_number": "360-993-3000",
            "fax_number": "360-993-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6926 NE FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-993-3000",
            "fax_number": "360-993-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00145585",
            "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 8, 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.

Verify at the official NPI Registry.