Organization Active NPI

Pacific Clinical Services PLLC

  • Health Service Clinic/Center
  • Vancouver, WA
National Provider Identifier
1124787635
Registry record updated Dec 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PACIFIC CLINICAL SERVICES PLLC
Practice address
3801 Main St Ste a
Vancouver, WA 98663-2258
Phone
(360) 787-4777
Fax
(360) 857-0500
NPI assigned
Dec 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2021

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

Authorized official

Name
Janet Coleman, RPHNPI 1083053227
Title
Pharmacist / Member
Phone
(360) 787-4777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3801 Main St Ste a
Vancouver, WA 98663-2258

Mailing address

PO Box 2206
Woodland, WA 98674-0021
Phone (360) 787-4777

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639267200000",
    "number": "1124787635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2206",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986740021",
            "telephone_number": "360-787-4777",
            "fax_number": "360-857-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MAIN ST STE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632258",
            "telephone_number": "360-787-4777",
            "fax_number": "360-857-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-12",
        "last_updated": "2021-12-12",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PHARMACIST / MEMBER",
        "authorized_official_telephone_number": "360-787-4777",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "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 Dec 12, 2021; 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.