Provider Demographics
NPI:1316596828
Name:POAGE, CARA (RN)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:
Last Name:POAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HESLEP LN
Mailing Address - Street 2:
Mailing Address - City:MCCLEARY
Mailing Address - State:WA
Mailing Address - Zip Code:98557-9421
Mailing Address - Country:US
Mailing Address - Phone:360-878-0718
Mailing Address - Fax:
Practice Address - Street 1:322 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:MCCLEARY
Practice Address - State:WA
Practice Address - Zip Code:98557-9522
Practice Address - Country:US
Practice Address - Phone:360-205-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60174761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse