Individual provider Active NPI

Katie Elaine White, AUD

  • Audiologist
  • Longview, WA
National Provider Identifier
1134612823
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD60965806 Issued in WA
Practice address
1801 1St Ave Ste 3a
Longview, WA 98632-3271
Phone
(360) 636-4469
NPI assigned
Jun 7, 2018
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3672 ID
Audiologist 231H00000X LD60965806 WA Primary

Addresses

Primary practice location

1801 1St Ave Ste 3a
Longview, WA 98632-3271

Mailing address

1801 1St Ave Ste 3a
Longview, WA 98632-3271
Phone (360) 636-4469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829003353 WA Practitioner - Qualified Audiologist 6002150943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
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)

2621 NE 134TH St
Suite 300
Vancouver, WA 98686-3036
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3672IDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Aug 12, 2024 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Aug 12, 2024 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
Clearview Surgery Center, LLC PastSince Nov 1, 2018 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

2621 NE 134th St
Ste 300
Vancouver, WA 98686
Phone (360) 718-2355

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 5

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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1134612823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 1ST AVE STE 3A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323271",
            "telephone_number": "360-636-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 1ST AVE STE 3A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323271",
            "telephone_number": "360-636-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KATIE",
        "middle_name": "ELAINE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "3672",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60965806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.