Individual provider Active NPI

Mark J Cohen, CRNA, ARNP

  • Certified Registered Nurse Anesthetist
  • Vancouver, WA
National Provider Identifier
1811981764
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP300005237 Issued in WA
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 514-4026
NPI assigned
Sep 7, 2005
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP300005237 WA Primary
Certified Registered Nurse Anesthetist 367500000X 085073617CRNA OR
Certified Registered Nurse Anesthetist 367500000X AP30005237 WA

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

1319 NW 110TH St
Vancouver, WA 98685-4042
Phone (503) 317-2084

Other practice location 1

1319 NW 110th St
Vancouver, WA 98685-4042
Phone (503) 317-2084

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
085073617CRNAORMDCertified Registered Nurse Anesthetist
AP300005237WAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1811981764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 NW 110TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854042",
            "telephone_number": "503-317-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-4026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 NW 110th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986854042",
            "country_code": "US",
            "telephone_number": "503-317-2084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "CRNA, ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP300005237",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "085073617CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30005237",
            "primary": false
        }
    ],
    "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 Jun 10, 2024; 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.