Active NPI
Lisa Lynne Hoven, CNA
- Home Health Aide
- Longview, WA
National Provider Identifier
1255106175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 10057616
- Practice address
- 1700 Hudson St Ste 105
Longview, WA 98632-2931 - Phone
- (360) 504-0122
- NPI assigned
- Nov 21, 2023
- Last updated
- Nov 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 10057616 | WA | Primary |
Addresses
Primary practice location
1700 Hudson St Ste 105
Longview, WA 98632-2931
Mailing address
201 Rocky Point Rd
Kelso, WA 98626-4021
Phone (360) 751-2352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10057616 | WA | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eden Home Health of Clark County, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Eden Home Health
- Home Health Agency
- Vancouver, WA
- NPI 1538778295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1255106175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 ROCKY POINT RD",
"city": "KELSO",
"state": "WA",
"postal_code": "986264021",
"telephone_number": "360-751-2352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 HUDSON ST STE 105",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322931",
"telephone_number": "360-504-0122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOVEN",
"first_name": "LISA",
"middle_name": "LYNNE",
"credential": "CNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "WA",
"license": "10057616",
"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 Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.