PERFORMANCE OCCUPATIONAL HEALTH SERVICES LLC (NPI# 1144795196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144795196 |
| Entity Type | Organization |
| Organization Name | PERFORMANCE OCCUPATIONAL HEALTH SERVICES LLC |
| Practice Address |
11109 Ne 14th St Ste A Vancouver WA 98684-4366 |
| Practice Telephone | 3603347001 |
| Practice Fax Number | 3604503357 |
| Mailing Telephone | 3603347001 |
| Mailing Fax Number | 3604503357 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |
| Authorized Official Name | MRS. CHARISE BRENES (PRESIDENT) |
| Authorized Official Telephone | 3603347001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0106X |
Nurse Practitioner Specialization: Occupational Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PERFORMANCE OCCUPATIONAL HEALTH SERVICES LLC | 11109 Ne 14th St, Ste A, Vancouver, WA 98684-4366 |
| Street Address |
11109 NE 14TH ST STE A |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-4366 |
| 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 | 363LX0106X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Occupational Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104128545 | Laura Dawn Hahn | Nurse Practitioner | 409 So. 12th Ave, Yakima, WA 98908 | 2010-11-17 |
| 1821028333 | Diane M Nelson | Nurse Practitioner | 803 Vandercook Way Ste 2, Lower Columbia Occupational Health, Longview, WA 98632-4039 | 2006-07-03 |
| 1316423833 | Hiedi Sutton | Nurse Practitioner | 1930 Port of Tacoma Rd, Tacoma, WA 98421-3707 | 2018-07-17 |
| 1518456847 | North End Medical Professional Corporation | Nurse Practitioner | 1186 S Burlington Blvd, Burlington, WA 98233-3314 | 2018-05-02 |
| 1417246067 | Christopher W. Benner | Nurse Practitioner | 1029 N Kellogg St, Kennewick, WA 99336-7661 | 2011-04-05 |
| 1295851707 | Jody R. Underwood | Nurse Practitioner | 246 N Mission St, Wenatchee, WA 98801-2004 | 2007-03-22 |
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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.