NPIMap

Organization Active NPI

Vancouver ENT and ENT of the Northwest PLLC

  • Clinic/Center
  • Vancouver, WA
National Provider Identifier
1780755876
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
602 593 569 Issued in WA
Legal business name
VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC
Doing business as
Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic
Practice address
1405 SE 164TH Ave
Suite 102
Vancouver, WA 98683-9644
Phone
(360) 256-4425
Fax
(360) 256-2474
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Mrs. Stephanie Hanks
Title
Practice Manager
Phone
(360) 256-4425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 602 593 569 WA Primary

Addresses

Primary practice location

1405 SE 164TH Ave
Suite 102
Vancouver, WA 98683-9644

Mailing address

1405 SE 164TH Ave
Suite 102
Vancouver, WA 98683-9644
Phone (360) 256-4425

Other identifiers 2

IdentifierTypeStateIssuer
7135486MedicaidWA
DF7194OtherWARAILROAD MEDICARE GROUP

Other names 1

  • Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

14411 NE 20th Ave
Vancouver, WA 98686
Phone (360) 574-9293

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1780755876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-254-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-256-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "HANKS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "360-256-4425",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "602 593 569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7135486",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DF7194",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 28, 2015; 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.