NPIMap

Individual provider Active NPI

Weiya Wysham, M.D.

  • Gynecologic Oncology Physician
  • Vancouver, WA
National Provider Identifier
1730322702
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MD.60622763 Issued in WA
Practice address
210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone
(360) 944-9889
NPI assigned
Apr 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD175715 OR
Gynecologic Oncology Physician 207VX0201X MD.60622763 WA Primary

Addresses

Primary practice location

210 SE 136TH Ave
Vancouver, WA 98684-6930

Mailing address

1498 SE Tech Center PL Ste 240
Vancouver, WA 98683-5508
Phone (360) 597-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160902001519 WA Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 2264687847 Reassigns benefits to 2 organizations
I20160902001591 OR Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 2264687847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
University of Washington School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889

265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.60622763WAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Aug 29, 2016 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 29, 2016 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 29, 2016 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Aug 29, 2016 Accepting new patients
Northwest Cancer Specialists, PC CurrentSince Mar 1, 2021 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1130 NW 22nd Ave
Ste 110
Portland, OR 97210
Phone (503) 413-3940

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

1498 SE Tech Center Pl
Ste 240
Vancouver, WA 98683
Phone (360) 597-1309

2121 NE 139th St
Ste 120
Vancouver, WA 98686
Phone (360) 487-1717

Interoperability endpoints

  • Direct secure messaging: wwysham154914@direct.ohsu.edu
  • Direct secure messaging: weiya.wysham@compass.ikm.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1730322702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835508",
            "telephone_number": "360-597-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SE 136TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846930",
            "telephone_number": "360-944-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSHAM",
        "first_name": "WEIYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OR",
            "license": "MD175715",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "WA",
            "license": "MD.60622763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.