Individual provider Active NPI

Sally Elizabeth Doyle, MD

  • Obstetrics Physician
  • Vancouver, WA
National Provider Identifier
1790886026
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MD00045384 Issued in WA
Practice address
2211 NE 139TH St
Vancouver, WA 98686-2742
Phone
(360) 487-4295
Fax
(360) 487-5049
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X MD00045384 WA Primary
Obstetrics Physician 207VX0000X MD26234 OR

Addresses

Primary practice location

2211 NE 139TH St
Vancouver, WA 98686-2742

Mailing address

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-4295

Other identifiers 2

IdentifierTypeStateIssuer
005801MedicaidOR
8438681MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00045384WAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC Obstetrics CurrentSince Nov 2, 2013 Accepting new patients

Locations

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

1130 NW 22nd Ave
Ste 500
Portland, OR 97210
Phone (503) 229-7339

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790886026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862742",
            "telephone_number": "360-487-4295",
            "fax_number": "360-487-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862742",
            "telephone_number": "360-487-4295",
            "fax_number": "360-487-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "SALLY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WA",
            "license": "MD00045384",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OR",
            "license": "MD26234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005801",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8438681",
            "state": "WA"
        }
    ],
    "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 Jul 8, 2007; 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.