NPIMap

Organization Active NPI

Vancouver ENT & ENT of the Northwest PLLC

  • Physical Therapy Clinic/Center
  • Vancouver, WA
National Provider Identifier
1487854618
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
VANCOUVER ENT & ENT OF THE NORTHWEST PLLC
Practice address
14411 NE 20TH Ave
Ste 101
Vancouver, WA 98686-6431
Phone
(360) 256-4425
Fax
(360) 260-7249
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Mr. Nathan J Geigle
Title
Practice Administrator
Phone
(360) 449-6612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

14411 NE 20TH Ave
Ste 101
Vancouver, WA 98686-6431

Mailing address

1405 SE 164TH Ave
Ste 102
Vancouver, WA 98683-9644
Phone (360) 256-4425

Other identifiers 1

IdentifierTypeStateIssuer
7135460MedicaidWA

Other names 1

  • Pacific Balance and Dizziness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vancouver Ear Nose Throat Head Neck Surgery Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1487854618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE",
            "address_2": "STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 NE 20TH AVE",
            "address_2": "STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866431",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER ENT & ENT OF THE NORTHWEST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "GEIGLE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-449-6612",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7135460",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Balance and Dizziness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 25, 2007; 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.