Healthcare Provider Details

I. General information

NPI: 1114877412
Provider Name (Legal Business Name): KHYLA MAE CALHOUN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 NE 112TH AVE STE 106
VANCOUVER WA
98684-5115
US

IV. Provider business mailing address

811 NE 112TH AVE STE 106
VANCOUVER WA
98684-5115
US

V. Phone/Fax

Practice location:
  • Phone: 360-207-5178
  • Fax:
Mailing address:
  • Phone: 360-207-5178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP.70084488-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: