NW INTERVENTIONAL MEDICINE AND ORTHOPEDIC REHAB PLLC (NPI# 1982058814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982058814 |
| Entity Type | Organization |
| Organization Name | NW INTERVENTIONAL MEDICINE AND ORTHOPEDIC REHAB PLLC |
| Practice Address |
11802 Ne 65th St. Vancouver WA 98662 |
| Practice Telephone | 3602536883 |
| Practice Fax Number | 3608927040 |
| Mailing Telephone | 3602536883 |
| Mailing Fax Number | 3608927040 |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |
| Authorized Official Name | MIKE BACK (OWNER/MANAGER) |
| Authorized Official Telephone | 3602536883 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11802 NE 65TH ST. |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024911 | Hillary Ann Devore | Behavior Technician | 9414 Ne Fouth Plain Road, Vancouver, WA 98662 | 2020-02-06 |
| 1073091781 | Jessica Edit Villasenor | Social Worker | 9800 Ne Oakview Dr, Vancouver, WA 98662 | 2018-08-03 |
| 1568991123 | Preferred Rx Pharmacy Inc | Pharmacy | 10303 Ne Fourth Plain Blvd Ste 109, Vancouver, WA 98662 | 2017-06-07 |
| 1942685664 | Silpa Nekkalapudi | Dentist | 11504 Ne 119th St, Suite 100, Vancouver, WA 98662 | 2015-07-23 |
| 1528468261 | Lidiya Chepa | Pharmacist | 14505 Ne Fourth Plain Boulevard, Vancouver, WA 98662 | 2014-08-29 |
| 1962827030 | Vanessa Wulff | Chiropractor | 6405 Ne 116th Ave Ste 106, Vancouver, WA 98662 | 2014-02-26 |
| 1326484080 | Precious Jewel Adult Family Home | Custodial Care Facility | 9707 Ne 115th Ct, Vancouver, WA 98662 | 2013-05-21 |
| 1457698466 | Elise C Jones | Counselor | 4400 Ne 77th Ave., Suite 275, Vancouver, WA 98662 | 2013-01-10 |
| 1396096103 | At Home Sleep Solutions | Clinic/Center | 9330 Ne Vancouver Mall Dr., Suite 202, Vancouver, WA 98662 | 2012-09-20 |
| 1467702274 | Molly Lyn Sprague | Mechanotherapist | 5501 Ne 109th Ct Ste L, Vancouver, WA 98662 | 2012-09-19 |
| Find all providers in zip 98662 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194128116 | Kimberlee Tess | Physician Assistant | 13003 Ne 46th St, Vancouver, WA 98682-6465 | 2014-10-04 |
| 1689977852 | Maliheh Razavi | Physician Assistant | 14508 Nw 20th Ave Ste 102, Vancouver, WA 98685 | 2010-12-10 |
| 1093936122 | Dan Lee Osborne | Physician Assistant | 4421 Ne St. Johns Blvd, Suite F, Vancouver, WA 98661-2573 | 2007-05-02 |
| 1629158464 | Joseph No Middle Name Marzucco | Physician Assistant | 406 Se 131st Ave Ste 101, Vancouver, WA 98683-4031 | 2006-10-16 |
| 1124571971 | Rebecca Rowney | Physician Assistant | 2525 Ne 139th St, Vancouver, WA 98686-2719 | 2016-07-28 |
| 1750751285 | Rolando Mendez | Physician Assistant | 100 E 33rd St, Suite 100, Vancouver, WA 98663-2776 | 2015-09-26 |
| 1356734966 | Jeffery Smith | Physician Assistant | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2015-03-07 |
| 1447640347 | Vancouver Chiropractic Group | Physician Assistant | 16821 Se Mcgillivray Blvd, Suite 204, Vancouver, WA 98683-0499 | 2015-01-29 |
| 1689077059 | Aaron Fordice | Physician Assistant | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2014-09-30 |
| 1982033171 | Bryan Thomas Rhoads | Physician Assistant | 9430 Ne Vancouver Mall Dr, Vancouver, WA 98662-6172 | 2013-11-07 |
| Find all providers in VANCOUVER | ||||
Please comment or provide details below to improve the information on NW INTERVENTIONAL MEDICINE AND ORTHOPEDIC REHAB PLLC.
| 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.