Healthcare Provider Details

I. General information

NPI: 1285056077
Provider Name (Legal Business Name): CIARA ENGERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14204 NE SALMON CREEK AVE
VANCOUVER WA
98686-9600
US

IV. Provider business mailing address

4001 Q ST
WASHOUGAL WA
98671-9058
US

V. Phone/Fax

Practice location:
  • Phone: 360-606-1397
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60623621
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: