Individual provider Active NPI

Joshua D Colley, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1417347915
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60555593 Issued in WA
Practice address
2529 NE 139TH St Ste 110
Vancouver, WA 98686-2719
Phone
(360) 882-2778
NPI assigned
Feb 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5962 AZ
Physician Assistant 363A00000X PA195076 OR
Physician Assistant 363A00000X PA60555593 WA Primary

Addresses

Primary practice location

2529 NE 139TH St Ste 110
Vancouver, WA 98686-2719

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

1321 NE 99th Ave Ste 100
Portland, OR 97220-9437
Phone (503) 215-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731016057 WA Practitioner - Physician Assistant 2860706041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2005 W Main St
Battle Ground, WA 98604-4311
Phone (360) 882-2778

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

2529 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

4500 SE Columbia Palisades Dr
Camas, WA 98607-8444
Phone (360) 882-2778

501 SE 172ND Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5962AZMDPhysician Assistant
PA195076ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince May 9, 2022 Accepting new patients
Cep America LLC CurrentSince Mar 1, 2022 Accepting new patients
Cep America LLC Physician Assistant CurrentSince Mar 1, 2022 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince May 9, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4500 SE Columbia Palisades Dr
Camas, WA 98607

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2529 NE 139th St
Ste 110
Vancouver, WA 98686

Interoperability endpoints

  • Direct secure messaging: jcolley19563@tvc-direct.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1417347915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 NE 139TH ST STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 NE 99th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972209437",
            "country_code": "US",
            "telephone_number": "503-215-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5962",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA195076",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60555593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.