Healthcare Provider Details

I. General information

NPI: 1639269533
Provider Name (Legal Business Name): NAOMI WARD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S MAIN AVE
DEER PARK WA
99006-0000
US

IV. Provider business mailing address

203 N WASHINGTON ST SUITE 300
SPOKANE WA
99201-0233
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-0286
  • Fax: 509-434-0286
Mailing address:
  • Phone: 509-444-8888
  • Fax: 509-444-7806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00098061
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10002776
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberAP30002106
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: