NPIMap

Organization Active NPI

Vancouver Guidance Clinic

  • Psychologist
  • Vancouver, WA
National Provider Identifier
1942607890
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 00000813 Issued in WA
Legal business name
VANCOUVER GUIDANCE CLINIC
Practice address
3112 Main St
Vancouver, WA 98663-2752
Phone
(360) 694-2016
Fax
(360) 694-8990
NPI assigned
Nov 20, 2014
Last updated
Nov 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Authorized official

Name
Dr. Christopher Kirk Johnson, PH.D.NPI 1265658066
Title
Clinic Director
Phone
(360) 694-2016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 00000813 WA Primary

Addresses

Primary practice location

3112 Main St
Vancouver, WA 98663-2752

Mailing address

3112 Main St
Vancouver, WA 98663-2752
Phone (360) 694-2016

National Provider Directory

National Provider Directory

Locations

3112 Main St
Vancouver, WA 98663
Phone (360) 694-2016

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1942607890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632752",
            "telephone_number": "360-694-2016",
            "fax_number": "360-694-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632752",
            "telephone_number": "360-694-2016",
            "fax_number": "360-694-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER GUIDANCE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "360-694-2016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY 00000813",
            "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 Nov 20, 2014; 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.