NPIMap

Organization Active NPI

Vancouver Spine & Orthopedic Rehabilition Center, PLLC

  • Specialist
  • Vancouver, WA
National Provider Identifier
1720247877
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CH00002774 Issued in WA
Legal business name
VANCOUVER SPINE & ORTHOPEDIC REHABILITION CENTER, PLLC
Practice address
11802 NE 65TH St
Vancouver, WA 98662-5521
Phone
(360) 253-6883
NPI assigned
Jun 4, 2008
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Mrs. Kristi Waggoner
Title
Office Manager
Phone
(360) 253-6883

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CH00002774 WA Primary
Specialist 174400000X PT00006628 WA

Addresses

Primary practice location

11802 NE 65TH St
Vancouver, WA 98662-5521

Mailing address

11802 NE 65TH St # 100
Vancouver, WA 98662-5521
Phone (360) 253-6883

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1720247877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11802 NE 65TH ST # 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625521",
            "telephone_number": "360-253-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11802 NE 65TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625521",
            "telephone_number": "360-253-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER SPINE & ORTHOPEDIC REHABILITION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-253-6883",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "CH00002774",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PT00006628",
            "primary": false
        }
    ],
    "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 28, 2008; 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.