MARK THOMAS HATTENHAUER (NPI# 1295740702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295740702 |
| Entity Type | Individual |
| Full Name | MARK THOMAS HATTENHAUER |
| Credential | MD |
| Practice Address |
1615 Delaware St Longview WA 98632-2367 |
| Mailing Address |
Po Box 3002 Longview WA 98632-0302 |
| Practice Telephone | 3604142730 |
| Practice Fax Number | 3604142739 |
| Mailing Telephone | 3604142730 |
| Mailing Fax Number | 3604142739 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD00028883 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD07556 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 085084 | 05 | |
| WA | 8563314 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740313345 | Mark A. Hattenhauer | Dentist | 636 S River Rd, Suite 201, Des Plaines, IL 60016-4624 | 2007-03-13 |
| Street Address |
1615 DELAWARE ST |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225094956 | Rajeev Singh | Internal Medicine | 709 Hollybrook Dr Ste 2301, Longview, TX 75605-2412 | 2006-04-21 |
| 1316909419 | James Anthony Suero | Internal Medicine | 1615 Deleware, Specialties Clinic, Longview, WA 98632 | 2006-04-04 |
| 1285613851 | Peter J Macander | Internal Medicine | 703 E Marshall Ave Ste 5008, Longview, TX 75601 | 2006-01-12 |
| 1740714534 | Dhruv Rajpurohit | Internal Medicine | 700 E Marshall Ave, Longview, TX 75601-5580 | 2017-04-18 |
| 1174942643 | Olubadewa Fatunde | Internal Medicine | 700 E Marshall Ave, Longview, TX 75601-5580 | 2014-04-14 |
| 1528323953 | Khashayar Kash Vahdat | Internal Medicine | 703 E Marshall Ave, Suite 5008, Longview, TX 75601-5500 | 2012-07-11 |
| 1235333808 | Jonathan David Greifenkamp | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2007-06-14 |
| 1275543274 | James Edward Farr Jr. | Internal Medicine | 1205 E Marshall Ave, Va Medical Clinic, Longview, TX 75601-5649 | 2006-08-09 |
| 1306850227 | Shafik Hanna-moussa | Internal Medicine | 703 E Marshall Ave Ste 5008, Longview, TX 75601-5557 | 2006-07-28 |
| 1043287816 | Samir V Germanwala | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-03-01 |
| Find all providers in LONGVIEW | ||||
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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.