Provider Demographics
NPI:1174000178
Name:ERNST, EMILY K (ARNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:ERNST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:ROUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EMILY ROUTH
Mailing Address - Street 1:2213 TRAIL VIEW ST
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506
Mailing Address - Country:US
Mailing Address - Phone:206-713-2000
Mailing Address - Fax:
Practice Address - Street 1:141 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5028
Practice Address - Country:US
Practice Address - Phone:360-413-8880
Practice Address - Fax:360-810-3697
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61046894363LW0102X, 363L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty