Carol Jane Han Cha, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

60547902 Issued in WA

Practice address

14508 NE 20TH Ave Ste 102
Vancouver, WA 98686-6434

Phone

(360) 852-9070

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  Family Medicine

  Medicare reassignment NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Vancouver, WA
  • NPI 1548318868

  Family Medicine

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642
  NPD

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1306103684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 NE 100TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623501",
            "telephone_number": "207-712-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434",
            "telephone_number": "360-852-9070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Benwood St",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785508532",
            "country_code": "US",
            "telephone_number": "956-389-2440 x2445",
            "fax_number": "956-389-2439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHA",
        "first_name": "CAROL",
        "middle_name": "JANE HAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q8850",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "45215",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60547902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Cerrato, PA-C
• Isabella Cervantes
• CH Lin, DDS, PLLC
• Frances CH'En, MD
• Arnold Cha, M.D.
• Jasmine J. Cha, D.D.S.
• Lyubov V. Chain
• Willow Chait
• Ksenia Chalambiyeva, CBT
• Jennifer Chamale

• Family Medicine Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.