Healthcare Provider Details

I. General information

NPI: 1740631720
Provider Name (Legal Business Name): ASHLEY HUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 33RD ST
VANCOUVER WA
98663-2238
US

IV. Provider business mailing address

605 MAIN ST #1043
VANCOUVER WA
98660-3129
US

V. Phone/Fax

Practice location:
  • Phone: 360-696-2561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: