NPIMap

Individual provider Active NPI

Ross Alan Vannorman, PAC

  • Medical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1134504103
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60999792 Issued in WA
Practice address
700 NE 87TH Ave Ste 220240
Vancouver, WA 98664-4896
Phone
(360) 882-2778
NPI assigned
Jul 20, 2015
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA172769 OR
Medical Physician Assistant 363AM0700X PA60999792 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave Ste 220240
Vancouver, WA 98664-4896

Mailing address

700 NE 87TH Ave Ste 220240
Vancouver, WA 98664-1913
Phone (360) 882-2778

Other identifiers 2

IdentifierTypeStateIssuer
2047684MedicaidWA
500690192MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200217002332 WA Practitioner - Physician Assistant 0143534693 Reassigns benefits to 2 organizations
I20200422000558 NY Practitioner - Physician Assistant 0143534693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
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)

14201 NE 20TH Ave
Vancouver, WA 98686-6410
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA172769ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians, PLLC CurrentSince Dec 23, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Dec 23, 2019 Accepting new patients
Peacehealth Past Accepting new patients
The Vancouver Clinic Inc PS PastSince Apr 8, 2026 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: rvannorman26357@tvc-direct.org
  • Direct secure messaging: rvannorman429392@direct.peacehealth.org

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1134504103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 220240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 220240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNORMAN",
        "first_name": "ROSS",
        "middle_name": "ALAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA172769",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60999792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047684",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500690192",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.