Active NPI
Mackenzie Lynne Nesbit Deane, MD
- Pediatrics Physician
- Vancouver, WA
National Provider Identifier
1962961185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD61428941
- Practice address
- 505 NE 87TH Ave Ste 120
Vancouver, WA 98664-1965 - Phone
- (360) 892-1635
- Fax
- (360) 892-3146
- NPI assigned
- Mar 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD61428941 | WA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
505 NE 87TH Ave Ste 120
Vancouver, WA 98664-1965
Mailing address
505 NE 87TH Ave Ste 120
Vancouver, WA 98664-1965
Phone (360) 892-1635
Other practice location 1
3181 SW Sam Jackson Road
Portland, OR 97239
Phone (503) 494-8211
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61428941 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Cardiology Center of Oregon PC | Past | Accepting new patients | |
| Evergreen Pediatric Clinic PS | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GIEBDD
- mnesbitdeane1463674@direct.lhs.org
Organizations & group practices 2
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.
-
- Pediatric Adolescent Medicine Physician
- Vancouver, WA
- NPI 1144343773
-
- Pediatric Cardiology Physician
- Portland, OR
- NPI 1144287541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1962961185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 NE 87TH AVE STE 120",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641965",
"telephone_number": "360-892-1635",
"fax_number": "360-892-3146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 NE 87TH AVE STE 120",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641965",
"telephone_number": "360-892-1635",
"fax_number": "360-892-3146"
}
],
"practiceLocations": [
{
"address_1": "3181 SW Sam Jackson Road",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "97239",
"country_code": "US",
"telephone_number": "503-494-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NESBIT DEANE",
"first_name": "MACKENZIE",
"middle_name": "LYNNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-18",
"last_updated": "2026-02-17",
"certification_date": "2026-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD61428941",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"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 Feb 17, 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.