Individual provider Active NPI

Kelly Rita Zahniser, LMP

  • Specialist
  • Vancouver, WA
National Provider Identifier
1861634313
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00021895 Issued in WA
Practice address
616 NE 81St St
Vancouver, WA 98665-8136
Phone
(360) 635-7574
NPI assigned
Mar 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00021895 WA Primary

Addresses

Primary practice location

616 NE 81St St
Vancouver, WA 98665-8136

Mailing address

4213 NE 138TH Ave
Vancouver, WA 98682-6938
Phone (360) 635-7574

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00021895WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1861634313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 NE 138TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986826938",
            "telephone_number": "360-635-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 NE 81ST ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658136",
            "telephone_number": "360-635-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHNISER",
        "first_name": "KELLY",
        "middle_name": "RITA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00021895",
            "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 Mar 30, 2009; 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.