Healthcare Provider Details

I. General information

NPI: 1720631260
Provider Name (Legal Business Name): SHERRY ILENE AINSWORTH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 SUMNER AVE
ABERDEEN WA
98520-4600
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 360-538-1293
  • Fax: 360-538-3908
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.60987835-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: