NPIMap

Organization Active NPI

Vancouver Clinic Inc

  • Community/Retail Pharmacy
  • Vancouver, WA
National Provider Identifier
1124063367
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHARCF00058559 Issued in WA
Legal business name
VANCOUVER CLINIC INC
Practice address
2525 NE 139TH St
Suite 160
Vancouver, WA 98686-2719
Phone
(360) 397-2880
Fax
(360) 604-1794
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Authorized official

Name
Larissa Morrow, PHARMD
Title
Pharmacy Manager
Phone
(360) 397-3880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHARCF00058559 WA Primary

Addresses

Primary practice location

2525 NE 139TH St
Suite 160
Vancouver, WA 98686-2719

Mailing address

2525 NE 139TH St
Pharmacy Suite 160
Vancouver, WA 98686-2719
Phone (360) 397-2880

Other identifiers 2

IdentifierTypeStateIssuer
6029078MedicaidWA
2108657OtherPK

Other names 1

  • VANCOUVER CLINIC PHARMACY SALMON CREEK Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vancover Clinic Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2525 NE 139th St
Ste 160
Vancouver, WA 98686
Phone (360) 397-2880

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1124063367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST",
            "address_2": "PHARMACY SUITE 160",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-397-2880",
            "fax_number": "360-604-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST",
            "address_2": "SUITE 160",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-397-2880",
            "fax_number": "360-604-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "360-397-3880",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF00058559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6029078",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108657",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VANCOUVER CLINIC PHARMACY SALMON CREEK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 16, 2016; 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.