MR. SETH MERCURIO (NPI# 1821340530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821340530 |
| Entity Type | Individual |
| Full Name | MR. SETH MERCURIO |
| Credential | NP |
| Practice Address |
784 14th Ave Longview WA 98632-2315 |
| Mailing Address |
1057 12th Ave Longview WA 98632-2509 |
| Practice Telephone | 3607036400 |
| Practice Fax Number | 3604141342 |
| Mailing Telephone | 3604259210 |
| Mailing Fax Number | 3602328400 |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2019-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP60314064 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2031323 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1251 Lewis River Rd Ste D, Woodland, WA 986749203 | 3602244310 | 3604141342 |
| 2232 S Silver Lake Rd, Castle Rock, WA 986118021 | 3602743262 | 3604141342 |
| 600 Broadway St, Longview, WA 986323256 | 3604259600 | 3604141342 |
| Street Address |
784 14TH AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083605778 | Daryl William Linnell | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2005-11-02 |
| 1750851846 | Irene Mudehwe | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2018-11-30 |
| 1467940486 | Jeb Bolerjack | Counselor | 784 14th Ave, Longview, WA 98632-2315 | 2018-04-25 |
| 1619418159 | Megan Minthorn | Registered Nurse | 784 14th Ave, Longview, WA 98632-2315 | 2017-03-16 |
| 1962876748 | Cowlitz Family Health Center | Clinic/Center | 784 14th Ave, Longview, WA 98632-2315 | 2015-11-17 |
| 1538357223 | Faith Ann Wilfley | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2007-10-09 |
| 1639287188 | Pediatric Clinic, Inc., P.s. | Clinic/Center | 784 14th Ave, Longview, WA 98632-2315 | 2006-08-25 |
| 1043238033 | Jan Carlin Khouri | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2006-07-17 |
| 1538147764 | Forrest G Mcgriff | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2006-01-06 |
| 1598756967 | Karen Sachiko Kato | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2005-11-03 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920247 | Lisa Kalynn Sanders | Nurse Practitioner | 2128 Page Creek Trl, Longview, TX 75601-0007 | 2020-10-20 |
| 1265030993 | Sarah Dawson | Nurse Practitioner | 2040 Eden Dr, Longview, TX 75601-3415 | 2020-10-14 |
| 1104455716 | Carol Henry | Nurse Practitioner | 287 E Cliffwood St, Longview, TX 75603-7556 | 2020-04-06 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1649821901 | Heather M Wilson | Nurse Practitioner | 2828 Bill Owens Pkwy Ste B, Longview, TX 75605-2102 | 2019-09-26 |
| 1942777826 | Cami Jo Tice-harouff | Nurse Practitioner | 16 Ramblewood Dr, Longview, TX 75605-3351 | 2018-10-29 |
| 1346778685 | Kyle Patrick Urbanek | Nurse Practitioner | 705 E Marshall Ave Ste 5000, Longview, TX 75601-5660 | 2017-05-31 |
| 1417481623 | Cody Castle | Nurse Practitioner | 1103 Eden Dr, Longview, TX 75605-3114 | 2017-04-13 |
| 1134570856 | Virginia Hardaway | Nurse Practitioner | 2953 Country Club Rd W, Longview, TX 75602-6861 | 2016-06-23 |
| 1275994824 | Alto Behavioral Health Services Pllc | Nurse Practitioner | 827 Lansing Switch Rd, Longview, TX 75602-7102 | 2016-03-10 |
| 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.