Healthcare Provider Details

I. General information

NPI: 1649673856
Provider Name (Legal Business Name): ARWA A SALTI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8506 E MILL PLAIN BLVD
VANCOUVER WA
98664-2011
US

IV. Provider business mailing address

3012 NE 163RD CT
VANCOUVER WA
98682-8678
US

V. Phone/Fax

Practice location:
  • Phone: 360-546-9350
  • Fax:
Mailing address:
  • Phone: 360-326-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP 60679769
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number201043577RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: