Provider Demographics
NPI:1124398524
Name:MAKOWSKI, ASHLEY L (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-8543
Mailing Address - Country:US
Mailing Address - Phone:360-852-7102
Mailing Address - Fax:
Practice Address - Street 1:2133 N 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-8543
Practice Address - Country:US
Practice Address - Phone:360-852-7102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201130648LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse