MR. SAMUEL LOPEZ (NPI# 1114167756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114167756 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL LOPEZ |
| Credential | PA-C |
| Practice Address |
203 Se Park Plaza Dr Ste 140 Vancouver WA 98684-5887 |
| Practice Telephone | 8008132000 |
| Mailing Telephone | 8008132000 |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2019-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA156712 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PAL-3102 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245887348 | Samuel Lopez | Non-emergency Medical Transport (VAN) | 17350 Temple Ave Spc 347, La Puente, CA 91744-4637 | 2019-08-22 |
| 1043874423 | Samuel Rogelio Lopez | Specialist/Technologist | 4106 N Yvette Dr, Pharr, TX 78577-7764 | 2019-04-30 |
| 1154675130 | Samuel Lopez | Counselor | 13177 Ramona Boulavard, Irwindale, CA 91706 | 2012-10-30 |
| 1083081921 | Samuel S Lopez | Physical Therapist | 4115 Pecan Blvd, Mcallen, TX 78501-3694 | 2015-08-26 |
| 1194169656 | Samuel W Lopez | Social Worker | 914 E Broadway, 2nd Floor, Louisville, KY 40204-1037 | 2013-04-26 |
| 1013183193 | Samuel Lopez | Dentist | 129 Grove St, Montclair, NJ 07042-4049 | 2008-05-07 |
| 1992842470 | Samuel D. Lopez | Counselor | 83912 Avenue 45, Suite 9, Indio, CA 92201-3338 | 2007-01-31 |
| Street Address |
203 SE PARK PLAZA DR STE 140 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-5887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275644585 | David Wayne Griffin | Podiatrist | 203 Se Park Plaza Dr Ste 140, Vancouver, WA 98684-5887 | 2006-08-31 |
| 1952966996 | Tatyana Ivanovna Molchanova | Registered Nurse | 203 Se Park Plaza Dr Ste 140, Vancouver, WA 98684-5887 | 2019-05-06 |
| 1518385285 | Anthony Maiolino | Podiatrist | 203 Se Park Plaza Dr Ste 140, Vancouver, WA 98684-5887 | 2014-03-31 |
| 1154404812 | Nathan W Greene | Orthopaedic Surgery | 203 Se Park Plaza Dr Ste 140, Vancouver, WA 98684-5887 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457343766 | Laura Deesha Ramme | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 410, Vancouver, WA 98664-3299 | 2005-08-22 |
| 1447720974 | Elizabeth A Eldenburg | Physician Assistant | 505 Ne 87th Ave Ste 250, Vancouver, WA 98664-1965 | 2018-11-27 |
| 1073996823 | Grace Deng | Physician Assistant | 505 Ne 87th Ave, Building A Suite 250, Vancouver, WA 98664-1989 | 2015-06-29 |
| 1164804647 | Jenny Lou Eldredge | Physician Assistant | 400 Ne Mother Joseph Place, Vancouver, WA 98664 | 2015-06-22 |
| 1194969717 | Mary-colleen D. Zucconi | Physician Assistant | 200 Ne Mother Joseph Pl Ste 110, Vancouver, WA 98664 | 2009-04-27 |
| 1982899365 | Jennifer D Hermes | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 210, Vancouver, WA 98664-3299 | 2007-09-10 |
| 1881702033 | Michael Walter Hibbs | Physician Assistant | 203 Se Park Plaza Dr, Vancouver, WA 98684-5886 | 2006-08-28 |
| 1093751703 | Kyle M. Richter | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| 1225074990 | Bonnie L. Rosenfeld | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| 1285670885 | Brett A. Rasmussen | Physician Assistant | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2006-06-21 |
| Find all providers in VANCOUVER | ||||
Please comment or provide details below to improve the information on MR. SAMUEL LOPEZ.
| 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.