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NPI Code Detail

MEDICARE: CHELSEA GWYNN BENNETT WHNP

MEDICARE:   CHELSEA GWYNN BENNETT  WHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerAP61368263WA

General Provider Information

NPI Number : 1669189635
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA GWYNN BENNETT WHNP
Provider Business Mailing Address
First Line : 4403 NE AINSWORTH ST
Second Line :
City : PORTLAND
State : OR
Zip : 97218-1353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11516 SE MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98684-5005
Country : US
Telephone Number : 503-801-6942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2022
Last Update Date : 10/31/2022

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Directions to “ CHELSEA GWYNN BENNETT WHNP” Practice Location

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