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General NPI Number Information
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NPI Number | 1760023469
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Entity Type | Individual
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Provider Name | DASHIEL WHAM NP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 1421 N MEADOWWOOD LN STE 30
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-5037
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Country | US
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Telephone | 509-990-9470
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Fax | 509-255-7790
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Provider Business Mailing Address
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Address Line | 4111 S HENRY RD
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City | GREENACRES
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State | WA
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Zip | 99016-6006
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Country | US
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Telephone | 206-557-8403
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 56675
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R44211
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61028233
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License Number State | WA
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