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PSA HEALTHCARE
NPI 1114956646
Nursing Care in Vancouver, WA

Active since June 30, 2006CLIA 50D0855571 · Waiver
2700 NE ANDRESEN RD, SUITE D-3, VANCOUVER, WA 98661(360) 693-7595(360) 693-7262 Get Directions Write a Review

NPPES record last updated: March 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 31, 2021, Oct 23, 2018 (2 updates tracked since 2018).

About Psa Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PSA HEALTHCARE (NPI 1114956646) is a healthcare organization registered as a nursing care in Vancouver, Washington and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Vicki Whiteside, Avp, Regulatory Licensing, as its authorized official.

NPPES Registry Identity

NPI1114956646
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NamePEDIATRIC SERVICES OF AMERICA, LLC
Location Address2700 NE ANDRESEN RD, SUITE D-3Vancouver, WA 98661-7347
Mailing Address400 Interstate North Pkwy Se Ste 1600Atlanta, GA 30339-5047 · (770) 441-1580 · Fax (770) 248-8192
Phone(360) 693-7595
Fax(360) 693-7262
Organization SubpartNo
Authorized OfficialVicki WhitesideAvp, Regulatory Licensing · (770) 248-8740
Enumeration DateJune 30, 2006
Last NPPES UpdateMarch 31, 20212 updates tracked since enumeration
NPPES CertifiedMarch 31, 2021
✔ NPI 1114956646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
Definition
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.
2700 NE ANDRESEN RD, Vancouver, WA 98661
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Other Names 2

Doing Business AsPsa Healthcare
Doing Business AsAveanna Healthcare

Other Identifiers 2

Medicaid746106WA
Medicaid9049561WA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0855571

Pediatric Services Of America LLC Dba Aveanna Healthcare · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D0855571
Laboratory TypeHome Health Agency
Certificate Effective DateSeptember 1, 1992
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJennifer Black
Laboratory Phone(360) 693-7595
Laboratory LocationPediatric Services Of America LLC Dba Aveanna Healthcare9105 NE Highway 99 Ste 202, Vancouver, WA 98665
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GAYLE DUKART-HARDY MSW
Social Worker (Clinical)
2700 NE ANDRESEN RD, SUITE D-9
VANCOUVER, WA 98661
Clark County (360) 694-8558
MISS OKSANA N GERASIMCHUK MASSAGE THERAPIST
Massage Therapist
2700 NE ANDRESEN RD, D11-A
VANCOUVER, WA 98661
Clark County (360) 609-6204
H & Y MEDICAL SUPPLIES, LLC
Durable Medical Equipment & Medical Supplies
2700 NE ANDRESEN RD, SUITE D14
VANCOUVER, WA 98661
Clark County (360) 693-9950
MRS. CYNTHIA GAIL VANEK L.M.P
Massage Therapist
2700 NE ANDRESEN RD, SUITE D11
VANCOUVER, WA 98661
Clark County (360) 910-1787

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Services Of America, LLC's NPI number?

The NPI number for Pediatric Services Of America, LLC is 1114956646. It was assigned to this organization in the NPPES registry on June 30, 2006. The provider is doing business as Psa Healthcare and Aveanna Healthcare.

Where is Pediatric Services Of America, LLC located?

Pediatric Services Of America, LLC is located at 2700 NE Andresen Rd Suite D-3, Vancouver, WA 98661. The listed phone number is (360) 693-7595.

What is Pediatric Services Of America, LLC's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

Does Pediatric Services Of America, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0855571) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric Services Of America, LLC was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.