Individual provider Active NPI

Maribonn Tiangson

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1982157996
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61334513 Issued in WA
Practice address
14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone
(800) 813-2000
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.068456 IL
Internal Medicine Physician 207R00000X MD61334513 WA Primary
Internal Medicine Physician 207R00000X 01082487A IN

Addresses

Primary practice location

14406 NE 20TH Ave
Vancouver, WA 98686-1448

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000

Other practice location 1

4646 N Marine Dr
Chicago, IL 60640-5759
Phone (773) 878-8700

Other practice location 2

3012 Franklin St
Michigan City, IN 46360-6144
Phone (219) 877-3841

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Maribonn.Tiangson@laportehosp.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221206001842 WA Practitioner - Internal Medicine 3274828603 Reassigns benefits to 1 organization
I20221206002240 OR Practitioner - Internal Medicine 3274828603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

1230 7TH Ave
Longview, WA 98632-3166
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.068456ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 3, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Oct 3, 2022 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

Interoperability endpoints

  • Direct secure messaging: maribonn.tiangson@laportehosp.cernerdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1982157996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "800-813-2000",
            "fax_number": "855-524-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 N Marine Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606405759",
            "country_code": "US",
            "telephone_number": "773-878-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3012 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "463606144",
            "country_code": "US",
            "telephone_number": "219-877-3841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIANGSON",
        "first_name": "MARIBONN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.068456",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61334513",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01082487A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Maribonn.Tiangson@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3777 N Frontage Rd",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463607695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.