| Columbia River Associates | |
|
6926 Ne Fourth Plain Blvd Vancouver WA 98661 | |
| (360) 993-3000 | |
| (360) 993-3047 |
| Full Name | Columbia River Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 6926 Ne Fourth Plain Blvd, Vancouver, Washington |
| Authorized Official Name and Position | Victor Jackson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3609933000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia River Associates Po Box 1337 Vancouver WA 98666-1337 Ph: (360) 993-3000 | Columbia River Associates 6926 Ne Fourth Plain Blvd Vancouver WA 98661 Ph: (360) 993-3000 |
| NPI Number | 1669411377 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Medicare PECOS PAC ID | 2860385309 |
|---|---|
| Medicare Enrollment ID | O20040206000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669411377 | NPI | - | NPPES |
| 1992775 | Medicaid | WA | |
| 7117195 | Medicaid | WA | |
| 06288 | Other | WA | REGENCE BCBS |
| 1980705 | Medicaid | WA | |
| 7035975 | Medicaid | WA | |
| 9630716 | Medicaid | WA | |
| 9234600 | Medicaid | WA |
| Provider Name | Teresa A Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962578179 PECOS PAC ID: 0648264812 Enrollment ID: I20040412000523 |
| Provider Name | Michael C Weyand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871586222 PECOS PAC ID: 7719939784 Enrollment ID: I20050217000741 |
| Provider Name | Jennifer Clingenpeel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992886956 PECOS PAC ID: 4486678547 Enrollment ID: I20060117000690 |
| Provider Name | Mark J Hubbard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811047731 PECOS PAC ID: 6901990241 Enrollment ID: I20070918000490 |
| Provider Name | Jessica A Feinman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528169331 PECOS PAC ID: 4486722535 Enrollment ID: I20081002000646 |
| Provider Name | George H Mecouch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336212208 PECOS PAC ID: 0749443281 Enrollment ID: I20120522000703 |
| Provider Name | Kevin D Fischer |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1184884082 PECOS PAC ID: 7719172444 Enrollment ID: I20121127000444 |
| Provider Name | Emily A Sadik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881857977 PECOS PAC ID: 7214168723 Enrollment ID: I20140326001939 |
| Provider Name | Eun K Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316122336 PECOS PAC ID: 3072639186 Enrollment ID: I20140421001795 |
| Provider Name | Sandra E Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538580147 PECOS PAC ID: 2062630700 Enrollment ID: I20140821002389 |
| Provider Name | Lesley A Kurjanowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497209340 PECOS PAC ID: 6305132101 Enrollment ID: I20160902001327 |
| Provider Name | Lisa M Aarseth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649676073 PECOS PAC ID: 4486081304 Enrollment ID: I20200305000365 |
| Provider Name | Christina Lee Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649682733 PECOS PAC ID: 0547688285 Enrollment ID: I20200914000639 |
| Provider Name | Ashley Elizabeth Wiersma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235646209 PECOS PAC ID: 0941561492 Enrollment ID: I20211216002634 |
| Provider Name | Marisa Goldfinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699433888 PECOS PAC ID: 0042680357 Enrollment ID: I20230103000890 |
| Provider Name | Sophia C Raevouri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689325144 PECOS PAC ID: 8325418585 Enrollment ID: I20230104000584 |
| Provider Name | Fiamma Lucio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942343231 PECOS PAC ID: 5395105308 Enrollment ID: I20230912001400 |
| Provider Name | Minna Wong Wurzer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457487274 PECOS PAC ID: 0547611600 Enrollment ID: I20240112002817 |
| Provider Name | Janet L Harper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184288029 PECOS PAC ID: 6709237860 Enrollment ID: I20240112002916 |
| Provider Name | Linda Rose Douglas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710059118 PECOS PAC ID: 6103278221 Enrollment ID: I20240113000636 |
| Provider Name | Rachel Madden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437538063 PECOS PAC ID: 9133571185 Enrollment ID: I20240116001828 |
| Provider Name | Jennifer Anne White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174898027 PECOS PAC ID: 7214380245 Enrollment ID: I20240125004708 |
| Provider Name | Michael Schlemeier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063764181 PECOS PAC ID: 4587017975 Enrollment ID: I20240201002725 |
| Provider Name | Kacie Lynn Hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588289771 PECOS PAC ID: 6204271646 Enrollment ID: I20240226001890 |
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