Healthcare Provider Details

I. General information

NPI: 1144136201
Provider Name (Legal Business Name): CHALICE JALENE ARDEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 FORTUYN RD
GRAND COULEE WA
99133-8718
US

IV. Provider business mailing address

411 FORTUYN RD
GRAND COULEE WA
99133-8718
US

V. Phone/Fax

Practice location:
  • Phone: 509-633-1753
  • Fax: 509-633-0295
Mailing address:
  • Phone: 509-633-1753
  • Fax: 509-633-0295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF08260895
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60776503
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: