MEDICARE: EWH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	UBI601998920	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841405982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EWH INC

Provider Business Mailing Address
First Line	:	1100 EASTSIDE ST SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-7304
Country	:	US
Telephone Number	:	360-943-5127
Fax Number	:	360-754-2516

Provider Business Practice Location Address
First Line	:	1100 EASTSIDE ST SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-7304
Country	:	US
Telephone Number	:	360-943-5127
Fax Number	:	360-754-2516

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	MS. SARA MAGNUSON-WHYTE
Credential	:	DNP, ARNP, PMHNP, BC
Telephone Number	:	360-943-5127

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	04/05/2013

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Directions to “EWH INC ” Practice Location

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