Provider Demographics
NPI:1174830806
Name:CHILCOTE, JOY MARIE (CNM, MN, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:MARIE
Last Name:CHILCOTE
Suffix:
Gender:F
Credentials:CNM, MN, ARNP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:MARIE
Other - Last Name:LUTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-303-6500
Practice Address - Fax:425-303-6550
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00131040163W00000X
WAAP60177838367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60177838OtherWASHINGTON STATE LICENSE
WARN00131040OtherWASHINGTON STATE LICENSE