Burdoin Mountain Maternity Care, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BURDOIN MOUNTAIN MATERNITY CARE, PLLC

Doing business as

Burdoin Mountain Medicine

Practice address

181 W Jewett Blvd
White Salmon, WA 98672-8974

Phone

(509) 289-2119

Fax

(509) 493-1264

NPI assigned

Nov 27, 2018

Last updated

May 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chardonnay Julia Vance, MD, PHDNPI 1164834347

Title

Physician, Owner

Phone

(509) 289-2119

Specialties & licenses 10

Addresses

Other names 1

• Burdoin Mountain Medicine Doing business as

Practitioners 1

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.

• Chardonnay Vance, MD PHD

  • Obstetrics Physician
  • White Salmon, WA
  • NPI 1164834347
  Authorized official Same address or phone

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1407326978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 886",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986720886",
            "telephone_number": "509-289-2119",
            "fax_number": "509-232-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W JEWETT BLVD",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986728974",
            "telephone_number": "509-289-2119",
            "fax_number": "509-493-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURDOIN MOUNTAIN MATERNITY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-27",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "CHARDONNAY",
        "authorized_official_middle_name": "JULIA",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "509-289-2119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burdoin Mountain Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margot R Bolstad, DO
• Shelby Taylor Bowerly, DNP, APRN, FNP-C
• Jillian Brown, LPC ASSOCIATE
• Nakia Bryan
• Jenny S Bunce, LCSW, MSW
• Camille Bush, CD(DONA)
• Eric Carpenter
• Patrick Carpenter
• Krista Clark
• Columbia River Gorge Behavior Services, LLC (Gorge Behavior Solutions)

• Clinic/Center in White Salmon, WA
• Providers in White Salmon, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.