Provider Demographics
NPI:1457305666
Name:SAVINON, CARLA EDWARDS (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:EDWARDS
Last Name:SAVINON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 SE 164TH AVE DEPT 358
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8004
Mailing Address - Country:US
Mailing Address - Phone:360-729-1462
Mailing Address - Fax:360-729-3104
Practice Address - Street 1:4545 CORDATA PKWY STE 2B
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226
Practice Address - Country:US
Practice Address - Phone:360-738-2200
Practice Address - Fax:360-752-5683
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201229363LF0000X
WAAP60710614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC58-2003803OtherHEALTH CARE SAVINGS
S95146Medicare UPIN
2599111Medicare ID - Type Unspecified