Provider Demographics
NPI:1487032520
Name:TUBB, ASHLEE (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:TUBB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:
Other - Last Name:TUBB-MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 PARKS RDG
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2973
Mailing Address - Country:US
Mailing Address - Phone:505-363-2281
Mailing Address - Fax:
Practice Address - Street 1:505 NE 87TH AVE STE 320
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1965
Practice Address - Country:US
Practice Address - Phone:360-514-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201502633NP-PP363LA2200X, 363LG0600X
WAAP60525660363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology