NPIMap

Organization Active NPI

Senior Connections Psychiatry PLLC.

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1174158125
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SENIOR CONNECTIONS PSYCHIATRY PLLC.
Practice address
9340 NE 76TH St
Vancouver, WA 98662-3721
Phone
(360) 253-4912
NPI assigned
Mar 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
David W Agnor, PH.D.
Title
Executive Director
Phone
(360) 253-4912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9340 NE 76TH St
Vancouver, WA 98662-3721

Mailing address

9340 NE 76TH St
Vancouver, WA 98662-3721
Phone (360) 253-4912

Other names 1

  • Senior Connections Psychiatry, PLLC. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1174158125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 NE 76TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623721",
            "telephone_number": "360-253-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 NE 76TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623721",
            "telephone_number": "360-253-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CONNECTIONS PSYCHIATRY PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "AGNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-253-4912",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Connections Psychiatry, PLLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 10, 2020; 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.