Active NPI
Lee Bendickson, CRNA
- Certified Registered Nurse Anesthetist
- Longview, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP60333564
- Practice address
- 1615 Delaware St
Longview, WA 98632-2367 - Phone
- (360) 414-2000
- Fax
- (360) 414-7638
- NPI assigned
- Jan 4, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 00169917 | WA | |
| Certified Registered Nurse Anesthetist | 367500000X | AP60333564 | WA | Primary |
Addresses
Primary practice location
1615 Delaware St
Longview, WA 98632-2367
Mailing address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-3885
Other practice location 1
900 Washington Rd
West Point, NY 10996-1109
Phone (845) 938-5169
Other practice location 2
9040 Jackson Ave
Tacoma, WA 98431
Phone (253) 968-3885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200325002175 | WA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6507144250 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peacehealth
Practice addresses (Care Compare)
1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814
1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800
Hospital & facility affiliations
- Peacehealth St John Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00169917 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current | Accepting new patients |
Locations
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Interoperability endpoints
- lbendickson433810@direct.peacehealth.org
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Longview, WA
- NPI 1073510277
-
- Prosthetic/Orthotic Supplier
- Longview, WA
- NPI 1184106437
-
- Urology Physician
- Longview, WA
- NPI 1255977591
-
- Durable Medical Equipment & Medical Supplies
- Longview, WA
- NPI 1801909171
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582156800000",
"number": "1336486786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-3885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322367",
"telephone_number": "360-414-2000",
"fax_number": "360-414-7638"
}
],
"practiceLocations": [
{
"address_1": "900 Washington Rd",
"address_purpose": "LOCATION",
"city": "West Point",
"state": "NY",
"postal_code": "109961109",
"country_code": "US",
"telephone_number": "845-938-5169",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9040 Jackson Ave",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "98431",
"country_code": "US",
"telephone_number": "253-968-3885",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENDICKSON",
"first_name": "LEE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-04",
"last_updated": "2020-02-20",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "00169917",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP60333564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.