Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP30003817 | WA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 200850161NP | OR |
N | 363LA2200X | Nurse Practitioner - Adult Health | AP30003817 | WA |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP30003817 | WA |
NPI | 1043241144 |
---|---|
Provider Name | Nicole M. Pashek |
First Address | The Dalles, OR 97058-0000 |
Second Address | The Dalles, OR 97058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 02/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0155780 | L&I PIN (01) | WA |
218105 | (05) | OR |
9632506 | (05) | WA |
S59219 | (02) | |
U19448 | REGENCE BLUE SHIELD PIN (01) | WA |