Great West Family Care PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

602202713 Issued in WA

Legal business name

GREAT WEST FAMILY CARE PC

Practice address

14508 NE 20TH Ave
Suite 102
Vancouver, WA 98686-6434

Phone

(360) 574-9730

Fax

(360) 576-7662

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca L Hoffman, MDNPI 1447225685

Title

President

Phone

(360) 574-9730

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Hoffman, MD

  • Family Medicine Physician
  • Vancouver, WA
  • NPI 1447225685
  NPD Authorized official
• Richard Peyton Carroll Jr., D.O.

  • Family Medicine Physician
  • Vancouver, WA
  • NPI 1619966744
  NPD (past)
• Jimmy Ming-Yuh Liao, MD

  • Family Medicine Physician
  • Portland, OR
  • NPI 1447212865
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1427073840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434",
            "telephone_number": "360-574-9730",
            "fax_number": "360-576-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434",
            "telephone_number": "360-574-9730",
            "fax_number": "360-576-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT WEST FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-574-9730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "602202713",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "602202713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7124530",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane P Graybill, RN
• Jordan Graybill, M.D.
• Shelley Ann Graybill, LMP
• Stephen Greaney, M.D.
• Great Northern Consulting (Great Northern Therapy Associates)
• Green Haven Home Care LLC (Veronica Escobar DBA Green Haven Home Care LLC)
• Annika Green
• Baroven Clark Green, RN
• Christine B Green, PSY.D.
• Conan Aram Green, MSW

• Primary Care Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.