NPIMap

Organization Active NPI

Lacamas Medical Group PC

  • Physician Assistant
  • Camas, WA
National Provider Identifier
1649280462
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003185 Issued in WA
Legal business name
LACAMAS MEDICAL GROUP PC
Practice address
3240 NE 3Rd Ave
Camas, WA 98607-2408
Phone
(360) 838-2440
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Scott Jonason
Title
President
Phone
(360) 838-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA10003185 WA Primary

Addresses

Primary practice location

3240 NE 3Rd Ave
Camas, WA 98607-2408

Mailing address

3240 NE 3Rd Ave
Camas, WA 98607-2408
Phone (360) 838-2440

Other identifiers 1

IdentifierTypeStateIssuer
7117096MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1649280462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-838-2440",
            "fax_number": "360-838-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-838-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACAMAS MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "JONASON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-838-2440"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117096",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.