Provider Demographics
NPI:1346510161
Name:ROSE, MARGARET ANN (ARNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:ROSE
Suffix:
Gender:F
Credentials:ARNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NE 160TH AVE STE #103 PMB #305
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684
Mailing Address - Country:US
Mailing Address - Phone:206-719-8870
Mailing Address - Fax:360-838-0310
Practice Address - Street 1:720 NE 160TH AVE STE #103 PMB #305
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684
Practice Address - Country:US
Practice Address - Phone:206-719-8870
Practice Address - Fax:360-838-0310
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002884363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346510161Other1346510161
WA1346510161Other1346510161