Active NPI
Mark Allen Kleinman, MD
- Family Medicine Physician
- Vancouver, WA
National Provider Identifier
1306935085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- WA MD 00025875
- Practice address
- 14406 NE 20TH Ave
Vancouver, WA 98686-1448 - Phone
- (360) 571-4200
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | WA MD 00025875 | WA | Primary |
Addresses
Primary practice location
14406 NE 20TH Ave
Vancouver, WA 98686-1448
Mailing address
12409 NW 48TH CT
Vancouver, WA 98685-3317
Phone (360) 574-0097
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA MD 00025875 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306935085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12409 NW 48TH CT",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986853317",
"telephone_number": "360-574-0097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14406 NE 20TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986861448",
"telephone_number": "360-571-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEINMAN",
"first_name": "MARK",
"middle_name": "ALLEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "WA MD 00025875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.