Peter J Mollenholt, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD00042002 Issued in WA

Practice address

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Phone

(360) 667-3056

Fax

(360) 666-0466

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1295723054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5157",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986685157",
            "telephone_number": "360-667-3056",
            "fax_number": "360-666-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-667-3056",
            "fax_number": "360-666-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLENHOLT",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00042002",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD21846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charis Mok
• Tatyana Ivanovna Molchanova
• Ernesto D Molina
• John Owen Mollahan, MS, LMHC, CRC
• Happiness Mollel
• Molly Kelly Molloy, M.D.
• Marjorie Louisa Molmen, MSW
• Tonya Molnar
• Crystal Lynn Monaghan, LMP
• Ellen Monaghan, P.T.

• Anesthesiology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Anesthesiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.