Healthcare Provider Details

I. General information

NPI: 1326456831
Provider Name (Legal Business Name): CHANTELLE PAULSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 07/21/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 E FOURTH PLAIN BLVD
VANCOUVER WA
98661-3965
US

IV. Provider business mailing address

2502 E FOURTH PLAIN BLVD
VANCOUVER WA
98661-3965
US

V. Phone/Fax

Practice location:
  • Phone: 360-558-5795
  • Fax: 360-397-8494
Mailing address:
  • Phone: 360-397-8494
  • Fax: 360-397-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61334748
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201607400RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: