Washougal Family Medicine, PS

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WASHOUGAL FAMILY MEDICINE, PS

Practice address

3307 Evergreen Way Ste 603
Washougal, WA 98671-2062

Phone

(360) 844-5858

Fax

(360) 838-4977

NPI assigned

Jul 11, 2019

Organization subpart

No

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

Authorized official

Name

Michele Dornbusch

Title

Office Manager

Phone

(360) 835-9911

Specialties & licenses 1

Addresses

Other names 1

• Washougal Family Medicine Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Dornbusch, D.C.

  • Chiropractor
  • Washougal, WA
  • NPI 1205837929
  NPD
• Samantha Arnold, LMT

  • Massage Therapist
  • Washougal, WA
  • NPI 1265927875
  NPD (past)
• Brenda Marie Harris

  • Massage Therapist
  • Washougal, WA
  • NPI 1801457486
  NPD (past)

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1194377937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 603",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712062",
            "telephone_number": "360-844-5858",
            "fax_number": "360-838-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 603",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712062",
            "telephone_number": "360-844-5858",
            "fax_number": "360-838-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHOUGAL FAMILY MEDICINE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "DORNBUSCH",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-835-9911"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washougal Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Camille Vollstedt, RDH
• Chih Wang
• Washougal Acupuncture and Massage, LLC
• Washougal Assisted Living, LLC
• Washougal Chiropractic Center, Inc
• Washougal School District
• Washougal Sport and Spine, Inc.
• Amanda Weil, LMT
• Rebecca Wilkie, LMT
• Laurie C Witt-Myers, CCC-SLP

• All providers in Washougal, WA
• Clinic/Center in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.