Ibrahim A Feyissa, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

70126165 Issued in WA

Practice address

180 NE 192ND Ave Ste 505
Vancouver, WA 98684-7525

Phone

(503) 305-6262

NPI assigned

Oct 14, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Specialty

General Practice

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1255151478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NE 192ND AVE STE 505",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986847525",
            "telephone_number": "240-839-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NE 192ND AVE STE 505",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986847525",
            "telephone_number": "503-305-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEYISSA",
        "first_name": "IBRAHIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "70126165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Mikeal Fettig, LD
• Arielle Fettman
• Andrew James Feustel
• Elizabeth S Feustel, REGISTERED NURSE
• Katie Fey, CCC-SLP
• Jennifer Ficco, RDH
• Sara Fiedler, MS
• Matilda Rose Field, CNM
• Charlonda Renee Fielder, MASSAGE THERAPIST
• Brandon Fielding, MSW, LICSW

• General Practice Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.