MEDICARE: CHERIE JAN RASH ARNP

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
1	363LF0000X	Family Nurse Practitioner	NP-1546A	ID
2	363LF0000X	Family Nurse Practitioner	AP60546657	WA

General Provider Information

NPI Number	:	1780077552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERIE JAN RASH ARNP

Provider Business Mailing Address
First Line	:	1207 EVERGREEN CT
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-2843
Country	:	US
Telephone Number	:	208-750-5643
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 EVERGREEN CT
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-2843
Country	:	US
Telephone Number	:	509-751-0600
Fax Number	:	509-751-8863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	04/20/2018

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