NPIMap

Organization Active NPI

Our Lady of Lourdes Health Center

Doing business as Lourdes West Pasco

  • Family Medicine Physician
  • Pasco, WA
National Provider Identifier
1659505840
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113003371 Issued in WA
Legal business name
OUR LADY OF LOURDES HEALTH CENTER
Doing business as
Lourdes West Pasco
Practice address
7425 Wrigley Drive
Pasco, WA 99301
Phone
(509) 545-6220
Fax
(509) 545-6842
NPI assigned
May 4, 2009
Last updated
Aug 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Authorized official

Name
John Serle
Title
Ceo
Phone
(509) 543-2483

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 113003371 WA Primary
Obstetrics & Gynecology Physician 207V00000X 113003371 WA

Addresses

Primary practice location

7425 Wrigley Drive
Pasco, WA 99301

Mailing address

7425 Wrigley Drive
Pasco, WA 99301
Phone (509) 545-6220

Other names 1

  • Lourdes West Pasco Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0710348Lourdes West Pasco Family Medicine7425 Wrigley Dr Ste 100, Pasco, WA 99301Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

7425 Wrigley Dr
Pasco, WA 99301
Phone (509) 416-8888

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1659505840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 WRIGLEY DRIVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "99301",
            "telephone_number": "509-545-6220",
            "fax_number": "509-545-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 WRIGLEY DRIVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "99301",
            "telephone_number": "509-545-6220",
            "fax_number": "509-545-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "SERLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-543-2483"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "113003371",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "113003371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lourdes West Pasco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.