NPIMap

Organization Active NPI

Walla Walla Vamc

  • VA Clinic/Center
  • Boardman, OR
National Provider Identifier
1457742538
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
WALLA WALLA VAMC
Practice address
2 Marine Drive
Suite 103
Boardman, OR 97818-9998
Phone
(702) 341-3164
NPI assigned
Feb 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Authorized official

Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

2 Marine Drive
Suite 103
Boardman, OR 97818-9998

Mailing address

PO Box 94423
Cleveland, OH 44101-4423
Phone (702) 341-3164

Other names 1

  • BOARDMAN VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Dept of Veteran Affairs11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1457742538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94423",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014423",
            "telephone_number": "702-341-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MARINE DRIVE",
            "address_2": "SUITE 103",
            "city": "BOARDMAN",
            "state": "OR",
            "postal_code": "978189998",
            "telephone_number": "702-341-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLA WALLA VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOARDMAN VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boardman, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.