ASSOCIATED VALLEY PROVIDERS PLLC (NPI# 1043490543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043490543 |
| Entity Type | Organization |
| Organization Name | ASSOCIATED VALLEY PROVIDERS PLLC |
| Practice Address |
4361 Talbot Rd S Suite 112 Renton WA 98055-6226 |
| Practice Telephone | 4252555111 |
| Practice Fax Number | 4252540985 |
| Mailing Telephone | 4252555111 |
| Mailing Fax Number | 4252540985 |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2009-09-22 |
| Authorized Official Name | DR. JOHN L VANDERHEYDEN (OWNER) |
| Authorized Official Telephone | 4252555111 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | WA | Allopathic & Osteopathic Physicians | |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
WA | Podiatric Medicine & Surgery Service Providers | |
| N | 363L00000X | Nurse Practitioner | WA | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7112634 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316249907 | Associated Valley Providers Pllc | Podiatrist | 4361 Talbot Rd S Ste 112, Renton, WA 98055-6226 | 2010-12-02 |
| Street Address |
4361 TALBOT RD S SUITE 112 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-6226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528068533 | Renton Sports & Spine Pt | Physical Therapist | 4361 Talbot Rd S, Suite 100, Renton, WA 98055-6226 | 2005-08-01 |
| 1568875789 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2014-06-05 |
| 1063725505 | David P Ruoff, Md, Inc, Ps. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2010-07-26 |
| 1356541882 | Children First Pediatrics, Pllc | Clinic/Center | 4361 Talbot Rd S, Suite 103, Renton, WA 98055-6226 | 2007-07-23 |
| 1841352143 | Orit Hickman | Specialist | 4361 Talbot Rd S, Ste 100, Renton, WA 98055-6226 | 2006-12-14 |
| 1578623690 | John L Vander Heyden | Obstetrics & Gynecology | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-11 |
| 1336208321 | Michael Brian Vickers | Podiatrist | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-06 |
| 1447319330 | Mary Louise Mckevitt | Registered Nurse | 4361 Talbot Rd S, Renton, WA 98055-6226 | 2006-12-06 |
| 1063584498 | Deborah Jean Ketterer | Podiatrist | 4361 Talbot Rd S, Suite 101, Renton, WA 98055-6226 | 2006-11-14 |
| 1043271927 | Steven L Summerfield | Orthopaedic Surgery | 4361 Talbot Rd S, #102, Renton, WA 98055 | 2006-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427672310 | Andrea Lauren Cistulli | Family Medicine | 3619 Talbot Rd S Ste 401, Renton, WA 98055-5708 | 2020-06-05 |
| 1639609803 | Kirsten Margaret Anderson | Family Medicine | 1205 N 10th St Ste 103-c, Renton, WA 98057-5577 | 2017-06-19 |
| 1366823742 | Timothy Asher | Family Medicine | 10555 Se Carr Rd # M, Renton, WA 98055-5820 | 2015-06-11 |
| 1508150152 | Kristin F Parker | Family Medicine | 3915 Talbot Rd S Ste 200, Renton, WA 98055-5738 | 2011-05-31 |
| 1124264577 | Kaiser Foundation Health Plan of Washington | Family Medicine | 2715 Naches Ave Sw, Gsw-a1n-02, Renton, WA 98057-2627 | 2009-01-06 |
| 1124204748 | Judith Lynn Molin | Family Medicine | Ne 8th Ave and Park Ave North, The Boeing Company, Renton, WA 98055 | 2008-01-14 |
| 1215012596 | William Zeev N Young | Family Medicine | 920 N 1st St, Renton, WA 98057-5759 | 2006-10-26 |
| 1285724831 | Paradigm Family Medicine Pllc | Family Medicine | 700 Sw 39th St, Suite 216, Renton, WA 98055-4952 | 2006-10-13 |
| 1568579092 | John K Mayeno | Family Medicine | 17900 Talbot Rd, S # 102, Renton, WA 98055 | 2006-08-23 |
| 1801817465 | Ronald Schubert | Family Medicine | 707 S Grady Way Ste 600, Renton, WA 98057-3227 | 2006-07-21 |
| Find all providers in RENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.