Individual provider Active NPI

Vernon Nessan, MD

  • Pulmonary Disease Physician
  • Puyallup, WA
National Provider Identifier
1881641686
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD00013833 Issued in WA
Practice address
702 23Rd Ave SE
Puyallup, WA 98372-4661
Phone
(253) 841-4378
Fax
(253) 841-5881
NPI assigned
May 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD00013833 WA Primary

Addresses

Primary practice location

702 23Rd Ave SE
Puyallup, WA 98372-4661

Mailing address

PO Box 40
Puyallup, WA 98371-0137
Phone (253) 697-5502

Other identifiers 6

IdentifierTypeStateIssuer
98372K003OtherWATRICARE PROVIDER NUMBER
NE2298OtherWAREGENCE RIDER NUMBER
91120349463OtherWAKPS PROVIDER NUMBER
0155123OtherWAL & I PROVIDER NUMBER
1665702MedicaidWA
4330437OtherWAAETNA PROVIDER NUMBER

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00013833WAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Community Healthcare Pulmonary Disease Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1881641686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710137",
            "telephone_number": "253-697-5502",
            "fax_number": "253-697-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 23RD AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724661",
            "telephone_number": "253-841-4378",
            "fax_number": "253-841-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESSAN",
        "first_name": "VERNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00013833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "98372K003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER NUMBER",
            "identifier": "NE2298",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS PROVIDER NUMBER",
            "identifier": "91120349463",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROVIDER NUMBER",
            "identifier": "0155123",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1665702",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4330437",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.