NPIMap

Organization Active NPI

Mobilehealthcareprovidersnorthwest

  • Voluntary or Charitable Agency
  • Vancouver, WA
National Provider Identifier
1487060901
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
603288428 Issued in WA
Legal business name
MOBILEHEALTHCAREPROVIDERSNORTHWEST
Practice address
415 SE 177TH Ave
Vancouver, WA 98683-4201
Phone
(360) 980-2441
Fax
(877) 491-4990
NPI assigned
Jul 3, 2014
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Mary Buckland, FNP-BCNPI 1912066986
Title
President/Ceo
Phone
(360) 980-2441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 603288428 WA Primary

Addresses

Primary practice location

415 SE 177TH Ave
Vancouver, WA 98683-4201

Mailing address

PO Box 728
Camas, WA 98607-0728
Phone (360) 980-2441

National Provider Directory

National Provider Directory
Tax ID family
Mobile Healthcare Providers Northwest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1487060901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986070728",
            "telephone_number": "360-980-2441",
            "fax_number": "877-491-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SE 177TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834201",
            "telephone_number": "360-980-2441",
            "fax_number": "877-491-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILEHEALTHCAREPROVIDERSNORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "BUCKLAND",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "360-980-2441",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "WA",
            "license": "603288428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.