Individual provider Active NPI

Lindsey Marjama-Taft

  • Family Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1164287751
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61517954 Issued in WA
Practice address
Neurology at Salmon Creek, 2121 N.E. 139TH St.
Medical Office Building a, Suite 205
Vancouver, WA 98686
Phone
(360) 487-4707
Fax
(360) 487-4709
NPI assigned
Feb 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10006831 OR
Neurology Physician 2084N0400X AP61517954 WA
Family Nurse Practitioner 363LF0000X AP61517954 WA Primary

Addresses

Primary practice location

Neurology at Salmon Creek, 2121 N.E. 139TH St.
Medical Office Building a, Suite 205
Vancouver, WA 98686

Mailing address

4421 W 58TH St Unit 12
Sioux Falls, SD 57108-6511
Phone (701) 799-7941

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301002013 WA Practitioner - Nurse Practitioner 8820433733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

2121 NE 139TH St
Suite 205
Vancouver, WA 98686-2316
Phone (503) 413-4488

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10006831ORMDNeurology Physician
AP61517954WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Feb 19, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Feb 19, 2024 Accepting new patients

Locations

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2121 NE 139th St
Ste 205
Vancouver, WA 98686
Phone (360) 487-4707

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1164287751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 W 58TH ST UNIT 12",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086511",
            "telephone_number": "701-799-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEUROLOGY AT SALMON CREEK, 2121 N.E. 139TH ST.",
            "address_2": "MEDICAL OFFICE BUILDING A, SUITE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-487-4707",
            "fax_number": "360-487-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARJAMA-TAFT",
        "first_name": "LINDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "10006831",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "AP61517954",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61517954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.