NPIMap

Organization Active NPI

Vancouver Clinic Inc

  • Community/Retail Pharmacy
  • Vancouver, WA
National Provider Identifier
1376688903
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR.CF.00057948 Issued in WA
Legal business name
VANCOUVER CLINIC INC
Practice address
501 SE 172ND Ave Ste 120
Vancouver, WA 98684-9542
Phone
(360) 397-3602
Fax
(360) 604-1791
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Larissa Morrow
Title
Pharmacy Manager
Phone
(360) 397-3314

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHAR.CF.00057948 WA Primary

Addresses

Primary practice location

501 SE 172ND Ave Ste 120
Vancouver, WA 98684-9542

Mailing address

501 SE 172ND Ave Ste 120
Vancouver, WA 98684-9542
Phone (360) 397-3602

Other identifiers 2

IdentifierTypeStateIssuer
6027991MedicaidWA
2108382OtherPK

Other names 1

  • THE VANCOUVER CLINIC PHARMACY Columbia Technology Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2140339The Vancouver Clinic - CTC501 SE 172ND Ave Ste 160, Vancouver, WA 98684ComplianceApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Vancover Clinic Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1376688903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-397-3602",
            "fax_number": "360-604-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-397-3602",
            "fax_number": "360-604-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "360-397-3314"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.00057948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6027991",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE VANCOUVER CLINIC PHARMACY Columbia Technology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.