Organization Active NPI

Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, PS

  • Clinic/Center
  • Vancouver, WA
National Provider Identifier
1912198748
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS
Practice address
14411 NE 20TH Ave
Suite 101
Vancouver, WA 98686-6431
Phone
(360) 256-4425
Fax
(360) 260-7249
NPI assigned
Aug 7, 2007
Last updated
Aug 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Mr. Nathan J Geigle
Title
Practice Manager
Phone
(360) 449-6612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X WA Primary

Addresses

Primary practice location

14411 NE 20TH Ave
Suite 101
Vancouver, WA 98686-6431

Mailing address

1405 SE 164TH Ave
Suite 102
Vancouver, WA 98683-9644
Phone (360) 256-4425

Other identifiers 1

IdentifierTypeStateIssuer
7068596MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Vancouver Ear Nose Throat Head Neck Surgery Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1912198748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 NE 20TH AVE",
            "address_2": "SUITE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866431",
            "telephone_number": "360-256-4425",
            "fax_number": "360-260-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER EAR, NOSE & THROAT HEAD & NECK SURGERY CLINIC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "GEIGLE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "360-449-6612",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068596",
            "state": "WA"
        }
    ],
    "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 Aug 7, 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.