Active NPI
Maria P. Magnuson, ARNP
- Obstetrics & Gynecology Nurse Practitioner
- Longview, WA
National Provider Identifier
1396742540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- AP30004093
- Practice address
- 1660 Delaware St
Peacehealth Women'S Health Pavilion
Longview, WA 98632-2310 - Phone
- (360) 414-2800
- Fax
- (360) 414-2803
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AP30004093 | WA | |
| Women's Health Nurse Practitioner | 363LW0102X | RN00080812 | WA | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | AP30004093 | WA | Primary |
Addresses
Primary practice location
1660 Delaware St
Peacehealth Women'S Health Pavilion
Longview, WA 98632-2310
Mailing address
1115 SE 164TH Avenue, Dept. 358
Vancouver, WA 98683
Phone (360) 414-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500657432 | Medicaid | OR | |
| 7002645 | Medicaid | WA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00080812 | WA | MD | Women's Health Nurse Practitioner |
| AP30004093 | WA | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377216000000",
"number": "1396742540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 SE 164TH AVENUE, DEPT. 358",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98683",
"telephone_number": "360-414-2800",
"fax_number": "360-414-2803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 DELAWARE ST",
"address_2": "PEACEHEALTH WOMEN'S HEALTH PAVILION",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322310",
"telephone_number": "360-414-2800",
"fax_number": "360-414-2803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNUSON",
"first_name": "MARIA",
"middle_name": "P.",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2013-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "AP30004093",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "WA",
"license": "RN00080812",
"primary": false
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "WA",
"license": "AP30004093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500657432",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7002645",
"state": "WA"
}
],
"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 Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.