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General NPI Number Information
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NPI Number | 1457042913
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Entity Type | Individual
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Provider Name | PASCAL THURAM HABIYAREMYE APRN
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Gender | Male
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 11801 NE 65TH ST STE A&B
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City | VANCOUVER
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State | WA
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Zip | 98662-5527
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Country | US
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Telephone | 360-558-5790
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Fax | 360-558-5791
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Provider Business Mailing Address
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Address Line | 4105 W SAINT CHARLES AVE
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City | PHOENIX
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State | AZ
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Zip | 85041-4980
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Country | US
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Telephone | 602-410-0159
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Fax | 360-558-5791
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP70069887
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RNP223694
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License Number State | AZ
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