NPIMap

Organization Active NPI

Arc of Clark County

  • Developmentally Disabled Services Day Training Agency
  • Vancouver, WA
National Provider Identifier
1376872929
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
PT60116751 Issued in WA
Legal business name
ARC OF CLARK COUNTY
Practice address
6511 NE 18TH St
Vancouver, WA 98661-6869
Phone
(360) 759-4917
Fax
(360) 759-4921
NPI assigned
Dec 10, 2009
Last updated
Dec 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Mrs. Tracylyn Broersma
Title
Medical Billing Specialist
Phone
(360) 759-4917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X PT60116751 WA Primary

Addresses

Primary practice location

6511 NE 18TH St
Vancouver, WA 98661-6869

Mailing address

PO Box 2277
Vancouver, WA 98668-2277
Phone (360) 759-4917

Other names 1

  • PRIDE For Kids Other name

National Provider Directory

National Provider Directory
Tax ID family
Arc of Clark County2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1376872929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2277",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986682277",
            "telephone_number": "360-759-4917",
            "fax_number": "360-759-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6511 NE 18TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616869",
            "telephone_number": "360-759-4917",
            "fax_number": "360-759-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARC OF CLARK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "BROERSMA",
        "authorized_official_first_name": "TRACYLYN",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "360-759-4917",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "WA",
            "license": "PT60116751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIDE For Kids",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 10, 2009; 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.