Individual provider Active NPI

Colleen McDevitt-Maslen, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1750925913
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2121 NE 139TH St
Vancouver, WA 98686-2301
Phone
(360) 487-1414
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2121 NE 139TH St
Vancouver, WA 98686-2301

Mailing address

2222 NW Lovejoy St
Portland, OR 97210-3033
Phone (503) 413-5787

Other practice location 1

2222 NW Lovejoy St
Portland, OR 97210-3033
Phone (503) 413-5787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191231002269 WA Practitioner - Physician Assistant 6901230804 Reassigns benefits to 1 organization
I20200121002026 OR Practitioner - Physician Assistant 6901230804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

19875 SW 65TH Ave
Tualatin, OR 97062-8353

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

2222 NW Lovejoy St
Portland, OR 97210-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Nov 25, 2019 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Nov 25, 2019 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Nov 25, 2019 Accepting new patients

Locations

2222 NW Lovejoy St
Ste 304
Portland, OR 97210
Phone (503) 274-4994

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

2222 NW Lovejoy St
Portland, OR 97210
Phone (503) 222-3638

19875 SW 65th Ave
Ste 250
Tualatin, OR 97062
Phone (503) 413-5525

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

2121 NE 139th St
Vancouver, WA 98686
Phone (360) 487-1777

2121 NE 139th St
Ste 430
Vancouver, WA 98686
Phone (360) 487-1414

Organizations & group practices 3

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 1

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": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1750925913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103033",
            "telephone_number": "503-413-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862301",
            "telephone_number": "360-487-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 NW Lovejoy St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103033",
            "country_code": "US",
            "telephone_number": "503-413-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDEVITT-MASLEN",
        "first_name": "COLLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.