Healthcare Provider Details

I. General information

NPI: 1811299696
Provider Name (Legal Business Name): HOWARD WAYLAND WELSH RN, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 CEMETERY RD
WINLOCK WA
98596-9303
US

IV. Provider business mailing address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

V. Phone/Fax

Practice location:
  • Phone: 360-785-9400
  • Fax: 360-785-0236
Mailing address:
  • Phone: 360-330-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN00076507
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP60198302
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: