MAGNOLIA PSYCHIATRIC SERVICES PLLC (NPI# 1417423989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417423989 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA PSYCHIATRIC SERVICES PLLC |
| Practice Address |
10000 Ne 7th Ave Ste 330f Vancouver WA 98685-4561 |
| Mailing Address |
301 Se 177th Ave Apt F66 Vancouver WA 98683-4223 |
| Practice Telephone | 3605678466 |
| Mailing Telephone | 4438236626 |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |
| Authorized Official Name | MRS. NADINE ANNICA SMITH (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Telephone | 4438236626 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10000 NE 7TH AVE STE 330F |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98685-4561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225650112 | Zachary Dodds | Massage Therapist | 12314 Nw 42nd Ct, Vancouver, WA 98685 | 2020-05-13 |
| 1760996425 | Eric Moore | Physical Therapy Assistant | 1308 Ne 134th Street, Suite 110, Vancouver, WA 98685 | 2017-11-16 |
| 1942711767 | Julie B Lawrence | Nurse Practitioner | 900 Ne 139th Street, Suite 202, Vancouver, WA 98685 | 2017-10-19 |
| 1538688668 | Carrie Roxann Wolfe | Counselor | 1313 Ne 134th St Ste 220a, Vancouver, WA 98685 | 2017-09-09 |
| 1548719461 | Mirror Pond Dental, LLC | Dentist | 1412 Ne 134th St. Suite 120, Vancouver, WA 98685 | 2016-10-04 |
| 1629522958 | Deanna Carter | Massage Therapist | 1319 Ne 134th Street, Vancouver, WA 98685 | 2016-08-03 |
| 1417329020 | Kaleen Hoyt | Massage Therapist | 1319 Nw 134th St Suit 103, Vancuver, WA 98685 | 2015-10-22 |
| 1497173066 | Kelley Heffelfinger | Behavioral Analyst | 9901 Ne 7th Ave., Suite C-116, Vancouver, WA 98685 | 2014-04-01 |
| 1548512791 | Elana S Kier | Social Worker | 10000 Ne 7th Ave Ste 100b, Vancouver, WA 98685 | 2012-10-12 |
| 1922370469 | Brian R Timms | Chiropractor | 1412 Ne 134th St Ste 100, Vancouver, WA 98685 | 2012-01-30 |
| Find all providers in zip 98685 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811408297 | Tms Nw Pllc | Nurse Practitioner | 5512 Ne 109th Ct Ste N, Vancouver, WA 98662-6175 | 2017-10-12 |
| 1164967246 | Ashley Leinani Bolan | Nurse Practitioner | 601 E 22nd St Ste C, Vancouver, WA 98663-3208 | 2016-12-28 |
| 1023455938 | Adina D Tarpley | Nurse Practitioner | 7210 Ne 14th Ct, Vancouver, WA 98665-0415 | 2013-05-31 |
| 1346428125 | Richard Stuart Keyser | Nurse Practitioner | 3305 Main St Ste 201, Vancouver, WA 98663-2250 | 2008-02-04 |
| 1407981095 | Kim L Carnahan Lewis | Nurse Practitioner | 1601 E Fourth Plain Blvd Bldg 17, Suite B222, Vancouver, WA 98661-3753 | 2007-02-22 |
| 1750318788 | Susan S. Rose | Nurse Practitioner | Legacy Salmon Creek Providers, 2211 Ne 139th Street, Vancouver, WA 98686-2742 | 2006-06-26 |
| 1073572269 | Julie A Dewitt-kamada | Nurse Practitioner | 3208 Ne 141st St, Vancouver, WA 98686-2260 | 2006-03-17 |
| 1821073081 | Janet Nickolaus | Nurse Practitioner | 2300 E Mill Plain Blvd, Vancouver, WA 98661-4332 | 2005-12-09 |
| 1285233627 | Kristy Hosley | Nurse Practitioner | 5512 Ne 109th Ct Ste I, Vancouver, WA 98662-6175 | 2020-10-17 |
| 1801406020 | Paladin Institute for Psychiatric Services | Nurse Practitioner | 4400 Ne 77th Ave Ste 275, Vancouver, WA 98662-6857 | 2020-08-03 |
| Find all providers in VANCOUVER | ||||
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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.