Free Clinic of Southwest Washington

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FREE CLINIC OF SOUTHWEST WASHINGTON

Practice address

4100 Plomondon St
Vancouver, WA 98661-5645

Phone

(360) 450-3054

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Rebecca O'Brien

Title

Executive Director

Phone

(360) 450-3054

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21026/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1851147862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PLOMONDON ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986615645",
            "telephone_number": "360-450-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PLOMONDON ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986615645",
            "telephone_number": "360-450-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE CLINIC OF SOUTHWEST WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-450-3054"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Lydia Fredeen, RD
• Danae Fredricksen, RN
• Linnea Fredriksson, M.D.
• Brandy M Free, LMP
• Jamie L Free
• Jeremy Edwin Free
• Marianne Freeborn
• Joseph David Nickolas Freeburg, M.D.

• Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.