Healthcare Provider Details

I. General information

NPI: 1447196167
Provider Name (Legal Business Name): NORTHWEST NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 NE CHATEAU DR
VANCOUVER WA
98661-2757
US

IV. Provider business mailing address

5503 NE CHATEAU DR
VANCOUVER WA
98661-2757
US

V. Phone/Fax

Practice location:
  • Phone: 360-719-8368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: KATIE JOHNSON
Title or Position: NURSE DELEGATOR
Credential: RN, BSN
Phone: 360-719-8368