Healthcare Provider Details

I. General information

NPI: 1245291541
Provider Name (Legal Business Name): CHERYL E EINERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL E ARNOTT

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4421 NE ST JOHNS RD STE F FAMILY CARE & URGENT MEDICAL CLINIC
VANCOUVER WA
98661-2573
US

IV. Provider business mailing address

13206 NE 227TH AVE
BRUSH PRAIRIE WA
98606-4203
US

V. Phone/Fax

Practice location:
  • Phone: 360-695-9922
  • Fax: 360-695-1310
Mailing address:
  • Phone: 306-607-9880
  • Fax: 360-892-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200050020NP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005665
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: