Healthcare Provider Details

I. General information

NPI: 1801526454
Provider Name (Legal Business Name): NATALIE PAUL PRIVATE PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 09/24/2023
Certification Date: 09/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 NE 109TH CT STE N
VANCOUVER WA
98662-6174
US

IV. Provider business mailing address

5501 NE 109TH CT STE N
VANCOUVER WA
98662-6174
US

V. Phone/Fax

Practice location:
  • Phone: 971-225-6970
  • Fax: 833-464-3458
Mailing address:
  • Phone: 971-225-6970
  • Fax: 833-464-3458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATALIE PAUL
Title or Position: NURSE PRACTITIONER
Credential: ARNP
Phone: 971-225-6970