Jessica K Chan, DO

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

OP60758015 Issued in WA

Practice address

700 NE 87TH Ave
Vancouver, WA 98664-1913

Phone

(360) 882-2778

Fax

(360) 604-1743

NPI assigned

Jun 3, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Geriatric Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Hospice Hospice, Vancouver, WA, CCN 501501
• Salmon Creek Post Acute & Rehabilitation Nursing home, Vancouver, WA, CCN 505522
• Avamere Rehabilitation of Cascade Park Nursing home, Vancouver, WA, CCN 505389

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jchan11635@tvc-direct.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment Care Compare group NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• Salmon Creek SNF Operations LLC

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1851099873
  NPD (past)
• The Vancouver Clinic Pharmacy

  • Pharmacist
  • Vancouver, WA
  • NPI 1336365857
  NPD (past)
• Vancouver Operations, LLC

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1194120816
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999

  Hospice

  Care Compare affiliation
• Peacehealth

  • Inpatient Hospice
  • Vancouver, WA
  • NPI 1558015057
  Care Compare affiliation
• Salmon Creek SNF Operations LLC

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1851099873

  Nursing home

  Care Compare affiliation
• Vancouver Operations, LLC

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1194120816

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124465901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873010",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986873010",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JESSICA",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG162770",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "OP60758015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2063530",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Anne Champion, P.T.
• Breya Chan-Strong, LMFT
• Alan Chan, B.S.
• Amy Chan
• David K Chan, DMD
• Judy Chan, O.D.
• Melanie Chan, RPH
• Shawn Chan, PHARM D
• Sikyin P Chan, EDD, LCSW
• Vivian Chan

• Geriatric Medicine (Internal Medicine) Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.