Southwest Washington Behavioral Health Regional Support Network

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

SOUTHWEST WASHINGTON BEHAVIORAL HEALTH REGIONAL SUPPORT NETWORK

Doing business as

Southwest Washington Behavioral Health

Practice address

1601 E Fourth Plain Blvd
BLDG. 17, Suite C214
Vancouver, WA 98661-3753

Phone

(360) 397-8222

Fax

(360) 397-6128

NPI assigned

Nov 26, 2012

Last updated

Nov 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Connie Mom-Chhing

Title

Chief Executive Officer

Phone

(360) 397-8222

Specialties & licenses 1

Addresses

Other names 1

• Southwest Washington Behavioral Health Doing business as

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1841534252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 664",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986660664",
            "telephone_number": "360-397-8222",
            "fax_number": "360-397-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD",
            "address_2": "BLDG. 17, SUITE C214",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "360-397-8222",
            "fax_number": "360-397-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST WASHINGTON BEHAVIORAL HEALTH REGIONAL SUPPORT NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "MOM-CHHING",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "360-397-8222",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Washington Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aruni N. K. Southard
• Lucy C Southerland, M.D.
• Stephen R. Southerland, M.D.
• Stephanie Southwell, RN
• Southwest GD Dental Corp, PC (dba Gentle Dental)
• Southwest Washington Med Ctr Outpatient Pharmacy
• Southwest Washington Medical Center
• Southwest Washington Medical Center Anticoagulation Clinic
• Southwest Washington Regional Health Alliance (Southwest Washington Accountable Community of Health)
• Southwest Washington Regional Surgery Center, LLC

• Exclusive Provider Organization in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Exclusive Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.