Provider Demographics
NPI:1295199107
Name:DEVARAJAN, ASHLEY NICHOLS (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICHOLS
Last Name:DEVARAJAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1319 NE 134TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2717
Mailing Address - Country:US
Mailing Address - Phone:360-885-7926
Mailing Address - Fax:360-882-0208
Practice Address - Street 1:1319 NE 134TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2717
Practice Address - Country:US
Practice Address - Phone:360-885-7926
Practice Address - Fax:360-882-0208
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60643404367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife