Active NPI
Laura Lynn Willoughby, M.D.
- Pulmonary Disease Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD61022155
- Practice address
- 700 NE 87TH Ave Ste 250
Vancouver, WA 98664-4896 - Phone
- (360) 882-2778
- Fax
- (360) 604-1727
- NPI assigned
- Apr 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD61022155 | WA | |
| Internal Medicine Physician | 207R00000X | 148408 | CA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD61022155 | WA | |
| Pulmonary Disease Physician | 207RP1001X | A148408 | CA | |
| Pulmonary Disease Physician | 207RP1001X | MD61022155 | WA | Primary |
Addresses
Primary practice location
700 NE 87TH Ave Ste 250
Vancouver, WA 98664-4896
Mailing address
PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159739 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- University of Nebraska College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
Hospital & facility affiliations
- Legacy Salmon Creek Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61022155 | WA | MD | Internal Medicine Physician |
| A148408 | CA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Internal Medicine | Current | Accepting new patients |
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| Regents of the Univ of Ca | Pulmonary Disease | Past | Accepting new patients |
| The Vancouver Clinic Pharmacy | Past | Accepting new patients | |
| Legacy Salmon Creek Hospital | Past | Accepting new patients |
Locations
700 NE 87th Ave
Ste 250
Vancouver, WA 98664
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
Interoperability endpoints
- lwilloughby16698@tvc-direct.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
-
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
- Eyewear Supplier
- Ridgefield, WA
- NPI 1760004477
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
- Pharmacist
- Vancouver, WA
- NPI 1336365857
-
- Pulmonary Disease Physician
- Sacramento, CA
- NPI 1437142692
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1922426055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4825",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084825",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE STE 250",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLOUGHBY",
"first_name": "LAURA",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-05",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD61022155",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "148408",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "WA",
"license": "MD61022155",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "A148408",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WA",
"license": "MD61022155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2159739",
"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 Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.