NPIMap

Organization Active NPI

Payette Clinics, PC

  • Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1629192075
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PAYETTE CLINICS, PC
Practice address
4210 NE 66TH Ave
Suite 111
Vancouver, WA 98661
Phone
(360) 216-4493
Fax
(360) 993-1800
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly Martene Bell, N.P.NPI 1467586883
Title
Owner
Phone
(360) 216-4493

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
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

4210 NE 66TH Ave
Suite 111
Vancouver, WA 98661

Mailing address

4210 NE 66TH Ave
Suite 111
Vancouver, WA 98661
Phone (360) 216-4493

Other identifiers 1

IdentifierTypeStateIssuer
9645193MedicaidWA

Other names 1

  • Payette Clinic Medical & Mental Health Care Doing business as

National Provider Directory

National Provider Directory

Locations

4201 NE 66th Ave
Ste 111
Vancouver, WA 98661
Phone (360) 216-4493

300 W 39th St
Vancouver, WA 98660
Phone (360) 216-4493

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629192075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 NE 66TH AVE",
            "address_2": "SUITE 111",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-216-4493",
            "fax_number": "360-993-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 NE 66TH AVE",
            "address_2": "SUITE 111",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-216-4493",
            "fax_number": "360-993-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYETTE CLINICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARTENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-216-4493",
        "authorized_official_credential": "N.P."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9645193",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payette Clinic Medical & Mental Health Care",
            "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 Aug 22, 2020; 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.