NPIMap

Organization Active NPI

Vancuver ENT and ENT Opf NW, PLLC

  • Hearing Aid Equipment
  • Longview, WA
National Provider Identifier
1669663936
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Aid EquipmentTaxonomy code 332S00000X
License
LD00001333 Issued in WA
Legal business name
VANCUVER ENT AND ENT OPF NW, PLLC
Practice address
1801 1St Ave
Suite 3a
Longview, WA 98632-3270
Phone
(360) 636-4469
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Authorized official

Name
Cheryl Jean Eby
Title
Office Manager
Phone
(360) 636-4469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X LD00001333 WA Primary

Addresses

Primary practice location

1801 1St Ave
Suite 3a
Longview, WA 98632-3270

Mailing address

1801 1St Ave
Suite 3a
Longview, WA 98632-3270
Phone (360) 636-4469

Other identifiers 1

IdentifierTypeStateIssuer
9059015MedicaidWA

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.

Locations

1801 1st Ave
Ste 3A
Longview, WA 98632
Phone (360) 256-4425

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1669663936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 1ST AVE",
            "address_2": "SUITE 3A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323270",
            "telephone_number": "360-636-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 1ST AVE",
            "address_2": "SUITE 3A",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323270",
            "telephone_number": "360-636-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCUVER ENT AND ENT OPF NW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "EBY",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-636-4469"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "WA",
            "license": "LD00001333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9059015",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.