Passport Health

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

PASSPORT HEALTH

Practice address

19101 36 Avenue W
Suite 208
Lynwood, WA 98036

Phone

(877) 358-8648

Fax

(877) 877-6875

NPI assigned

Feb 21, 2023

Last updated

Feb 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victoria Sowards, BSN, RN

Title

Director Compliance

Phone

(480) 646-9028

Specialties & licenses 1

Addresses

Tax ID family

Passport Health Holdings LLC219 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Bembenek Travel Health Washington, PC

  dba Passport Health

  • Community Health Worker
  • Vancouver, WA
  • NPI 1417655267
  NPD tax ID

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1306544168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44 ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008",
            "telephone_number": "480-646-9028",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19101 36 AVENUE W",
            "address_2": "SUITE 208",
            "city": "LYNWOOD",
            "state": "WA",
            "postal_code": "98036",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "SOWARDS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR COMPLIANCE",
        "authorized_official_telephone_number": "480-646-9028",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy May Derksen, N.D.
• Evergreen Recovery Centers-Health Services
• Hidayet Taha Karapinar, DC
• Karen S. Keeton, L.M.H.C.
• Vanezza Minnick

• Public Health & General Preventive Medicine Physician in Lynwood, WA
• Providers in Lynwood, WA by specialty
• Public Health & General Preventive Medicine Physician in Washington

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

Verify at the official NPI Registry.