Healthcare Provider Details

I. General information

NPI: 1225666522
Provider Name (Legal Business Name): ASHLEY NICOLE GAING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/29/2024
Certification Date: 06/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NE 139TH ST STE 380
VANCOUVER WA
98686-2301
US

IV. Provider business mailing address

2121 NE 139TH ST STE 380
VANCOUVER WA
98686-2301
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-6862
  • Fax:
Mailing address:
  • Phone: 503-413-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberDO219788
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number20A20731
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberOP61540988
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: