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General NPI Number Information
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NPI Number | 1588854483
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE GERIATRICS, LLC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 38324 SE HIDDEN FALLS ROAD
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City | WASHOUGAL
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State | WA
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Zip | 98671
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Country | US
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Telephone | 360-335-1700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1293
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City | WASHOUGAL
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State | WA
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Zip | 98671-0928
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Country | US
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Telephone | 360-335-1700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EVE MARIE HYATT
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Credential | NP
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Telephone | 360-335-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | OR
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