NPIMap

Organization Active NPI

Nooksack Dental Clinic

  • Dentist
  • Everson, WA
National Provider Identifier
1891843769
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010128 Issued in WA
Legal business name
NOOKSACK DENTAL CLINIC
Practice address
6760 Mission Rd
Everson, WA 98247-9749
Phone
(360) 306-5151
Fax
(360) 306-5191
NPI assigned
Jan 8, 2007
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
NOOKSACK TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Mrs. Rosemary Morris, CDA
Title
Dental Office Manager
Phone
(360) 306-5151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00010128 WA Primary

Addresses

Primary practice location

6760 Mission Rd
Everson, WA 98247-9749

Mailing address

6760 Mission Rd
Everson, WA 98247-9749
Phone (360) 306-5151

National Provider Directory

National Provider Directory
Tax ID family
Nooksack Central Management System8 organizations share this tax ID, including this one
Part of
Nooksack Central Management System

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1891843769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 MISSION RD",
            "city": "EVERSON",
            "state": "WA",
            "postal_code": "982479749",
            "telephone_number": "360-306-5151",
            "fax_number": "360-306-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 MISSION RD",
            "city": "EVERSON",
            "state": "WA",
            "postal_code": "982479749",
            "telephone_number": "360-306-5151",
            "fax_number": "360-306-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOOKSACK DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOOKSACK TRIBE",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "DENTAL OFFICE MANAGER",
        "authorized_official_telephone_number": "360-306-5151",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everson, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.