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General NPI Number Information
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NPI Number | 1841405982
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Entity Type | Organization
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Legal Business Name | EWH INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 1100 EASTSIDE ST SE
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City | OLYMPIA
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State | WA
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Zip | 98501-7304
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Country | US
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Telephone | 360-943-5127
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Fax | 360-754-2516
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Provider Business Mailing Address
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Address Line | 1100 EASTSIDE ST SE
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City | OLYMPIA
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State | WA
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Zip | 98501-7304
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Country | US
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Telephone | 360-943-5127
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Fax | 360-754-2516
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MS. SARA MAGNUSON-WHYTE
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Credential | DNP, ARNP, PMHNP, BC
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Telephone | 360-943-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | UBI601998920
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License Number State | WA
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