Active NPI
Vera Pluschakov
- Adult Day Care Clinic/Center
- Lynden, WA
National Provider Identifier
1619365558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- License
- A750374
- Practice address
- 201 S Garden Dr
Lynden, WA 98264-1022 - Phone
- (360) 656-6890
- Fax
- (360) 656-6890
- NPI assigned
- Dec 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | A750374 | WA | Primary |
Addresses
Primary practice location
201 S Garden Dr
Lynden, WA 98264-1022
Mailing address
201 S Garden Dr
Lynden, WA 98264-1022
Phone (360) 656-6890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A750374 | WA | MD | Adult Day Care Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1619365558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S GARDEN DR",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982641022",
"telephone_number": "360-656-6890",
"fax_number": "360-656-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S GARDEN DR",
"city": "LYNDEN",
"state": "WA",
"postal_code": "982641022",
"telephone_number": "360-656-6890",
"fax_number": "360-656-6890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLUSCHAKOV",
"first_name": "VERA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "WA",
"license": "A750374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynden, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.