NPIMap

Organization Active NPI

Community Services Northwest

  • Community/Behavioral Health Agency
  • Vancouver, WA
National Provider Identifier
1720176894
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY SERVICES NORTHWEST
Practice address
1601 E Fourth Plain Blvd
BLDG 17 Suite B222
Vancouver, WA 98661-3753
Phone
(360) 397-8484
Fax
(360) 397-8494
NPI assigned
Oct 11, 2006
Last updated
Feb 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Mr. John P. Moren, RNNPI 1922746411
Title
Executive Director
Phone
(360) 397-8005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 602-237-149 WA
Community/Behavioral Health Agency 251S00000X WA Primary

Addresses

Primary practice location

1601 E Fourth Plain Blvd
BLDG 17 Suite B222
Vancouver, WA 98661-3753

Mailing address

PO Box 1845
Vancouver, WA 98668-1845
Phone (360) 397-8484

Other identifiers 1

IdentifierTypeStateIssuer
1994615MedicaidWA

Other names 1

  • Mental Health Northwest Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 142

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 142

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1720176894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681845",
            "telephone_number": "360-397-8484",
            "fax_number": "360-397-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD",
            "address_2": "BLDG 17 SUITE B222",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "360-397-8484",
            "fax_number": "360-397-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICES NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "MOREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-397-8005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "602-237-149",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Health Northwest",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 2, 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.