NPIMap

Organization Active NPI

NW Olive Clinic, LLC

  • Exclusive Provider Organization
  • Vancouver, WA
National Provider Identifier
1801261847
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
NT60548368 Issued in WA
Legal business name
NW OLIVE CLINIC, LLC
Practice address
302 E 37TH St
Vancouver, WA 98663-2212
Phone
(360) 258-0627
NPI assigned
Dec 2, 2015
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Sabah Targhi, N.D.NPI 1144616244
Title
Owner
Phone
(360) 258-0627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X NT60548368 WA Primary

Addresses

Primary practice location

302 E 37TH St
Vancouver, WA 98663-2212

Mailing address

302 E 37TH St
Vancouver, WA 98663-2212
Phone (360) 258-0627

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1801261847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E 37TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632212",
            "telephone_number": "360-258-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E 37TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632212",
            "telephone_number": "360-258-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW OLIVE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "TARGHI",
        "authorized_official_first_name": "SABAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-258-0627",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WA",
            "license": "NT60548368",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 2, 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.