Lewis A Vanosdel III, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G33962 Issued in CA

Practice address

1033 SW 152ND St
Navos Sunstone Youth Residential
Burien, WA 98166

Phone

(206) 829-1121

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Columbia Community Mental Health

  • Psychiatric Residential Treatment Facility
  • Saint Helens, OR
  • NPI 1174372999
  NPD (past)
• Columbia Community Mental Health

  • Addiction (Substance Use Disorder) Counselor
  • Saint Helens, OR
  • NPI 1861617359
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1417000852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11602 SW BREYMAN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972198400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 SW 152ND ST",
            "address_2": "NAVOS SUNSTONE YOUTH RESIDENTIAL",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98166",
            "telephone_number": "206-829-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOSDEL",
        "first_name": "LEWIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "UT",
            "license": "9213117-1205",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G-33962",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00033116",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G33962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Francis Van Den Bosch Jr., LMP
• Jaime Marisa Van Doughty, LMP
• Wendy Van Sickle, PTA
• John Vanbodegom, MD
• Sharon Kay Vanmeter, LPN
• Sarah A Vanston, MD
• Tatyana Ivanovna Vasilishin, DNP, ARNP
• Dee Dee Vasquez, PMHNP-BC
• Tomas Velan, M.D.
• Ireneo Cuneta Velasco Jr.

• Psychiatry Physician in Burien, WA
• Providers in Burien, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.