Organization Active NPI

Lower Columbia Pathologists PS

  • Anatomic Pathology & Clinical Pathology Physician
  • Longview, WA
National Provider Identifier
1174564025
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
LOWER COLUMBIA PATHOLOGISTS PS
Practice address
720 14TH Ave
Longview, WA 98632
Phone
(360) 425-5620
Fax
(360) 425-7219
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Sheila D Lynam, M.D.
Title
President
Phone
(360) 501-8306

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

720 14TH Ave
Longview, WA 98632

Mailing address

PO Box 3012
Longview, WA 98632
Phone (360) 425-5620

Other identifiers 1

IdentifierTypeStateIssuer
7139603MedicaidWA

National Provider Directory

National Provider Directory

Locations

1217 14th Ave
Longview, WA 98632
Phone (360) 425-5620

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1174564025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3012",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-425-5620",
            "fax_number": "360-425-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-425-5620",
            "fax_number": "360-425-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER COLUMBIA PATHOLOGISTS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "LYNAM",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-501-8306",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139603",
            "state": "WA"
        }
    ],
    "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 Nov 15, 2016; 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.