Active NPI
Alla Polyakov
- Registered Nurse
- Vancouver, WA
National Provider Identifier
1720424971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00141251
- Practice address
- 7029 NE Fairway Ave
Vancouver, WA 98662-3690 - Phone
- (360) 524-5653
- Fax
- (360) 314-2674
- NPI assigned
- May 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00141251 | WA | Primary |
Addresses
Primary practice location
7029 NE Fairway Ave
Vancouver, WA 98662-3690
Mailing address
7029 NE Fairway Ave
Vancouver, WA 98662
Phone (360) 524-5653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00141251 | WA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Royal Home Care, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Care Home Facility
- Vancouver, WA
- NPI 1982067591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368576000000",
"number": "1720424971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7029 NE FAIRWAY AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98662",
"telephone_number": "360-524-5653",
"fax_number": "360-314-2674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7029 NE FAIRWAY AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986623690",
"telephone_number": "360-524-5653",
"fax_number": "360-314-2674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLYAKOV",
"first_name": "ALLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-15",
"last_updated": "2013-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00141251",
"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 May 15, 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.