Organization Active NPI

Family Wellness Center

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1669893533
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY WELLNESS CENTER
Practice address
1000 SE Tech Center Dr Ste 120
Vancouver, WA 98683-5548
Phone
(360) 260-2773
NPI assigned
Dec 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Cyndi Williams
Title
Credentialing Coordinator
Phone
(360) 567-0322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1000 SE Tech Center Dr Ste 120
Vancouver, WA 98683-5548

Mailing address

1000 SE Tech Center Dr Ste 120
Vancouver, WA 98683-5548
Phone (360) 260-2773

Other identifiers 2

IdentifierTypeStateIssuer
7067986MedicaidWA
1629110945OtherWANPI #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1669893533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SE TECH CENTER DR STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835548",
            "telephone_number": "360-260-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SE TECH CENTER DR STE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835548",
            "telephone_number": "360-260-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CYNDI",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "360-567-0322"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7067986",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1629110945",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 19, 2013; 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.