NPIMap

Organization Active NPI

The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
National Provider Identifier
1760004477
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
THE VANCOUVER CLINIC INC PS
Practice address
2 S 56TH PL Ste 205
Ridgefield, WA 98642-3427
Phone
(360) 882-2778
Fax
(360) 604-1692
NPI assigned
May 15, 2020
Organization subpart
Yes
Parent organization
THE VANCOUVER CLINIC INC PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Alfred Seekamp, MD
Title
Chief Medical Officer
Phone
(360) 397-5532

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2 S 56TH PL Ste 205
Ridgefield, WA 98642-3427

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778

Other identifiers 1

IdentifierTypeStateIssuer
1046502MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000793 WA Part B Supplier - Clinic/Group Practice 3173436490 Receives reassigned benefits from 767 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vancouver, WA; Washougal, WA; Battle Ground, WA; Ridgefield, WA; Camas, WA

National Provider Directory

National Provider Directory
Part of
Vancover Clinic Inc

Locations

2005 W Main St
Battle Ground, WA 98604
Phone (360) 604-1600

12019 NE 99th St
Ste 1730
Vancouver, WA 98682

501 SE 172nd Ave
Vancouver, WA 98684

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 241

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 241

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1760004477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S 56TH PL STE 205",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423427",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VANCOUVER CLINIC INC PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE VANCOUVER CLINIC INC PS",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "SEEKAMP",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "360-397-5532",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1046502",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.