NPIMap

Organization Active NPI

Lutheran Community Services Northwest

  • Community/Behavioral Health Agency
  • Vancouver, WA
National Provider Identifier
1700218815
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
289 Issued in WA
Legal business name
LUTHERAN COMMUNITY SERVICES NORTHWEST
Practice address
3600 Main St
Suite 200
Vancouver, WA 98663-2236
Phone
(360) 694-5624
NPI assigned
Jul 31, 2013
Organization subpart
Yes
Parent organization
LUTHERAN COMMUNITY SERVICES NORTHWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Roberta Nestaas
Title
President/Ceo
Phone
(206) 901-1685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 289 WA Primary

Addresses

Primary practice location

3600 Main St
Suite 200
Vancouver, WA 98663-2236

Mailing address

4040 S 188TH St
Seatac, WA 98188-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050408000542 WA Part B Supplier - Clinic/Group Practice 1254237522 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA; Seatac, WA; Kennewick, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Lutheran Community Services North West

Locations

3600 Main St
Ste 200
Vancouver, WA 98663
Phone (360) 694-5624

Practitioners & affiliated clinicians

Practitioners 6

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": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1700218815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 S 188TH ST",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981885070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MAIN ST",
            "address_2": "SUITE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632236",
            "telephone_number": "360-694-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN COMMUNITY SERVICES NORTHWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN COMMUNITY SERVICES NORTHWEST",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "NESTAAS",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "206-901-1685"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "289",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.