Provider Demographics
NPI:1518001668
Name:OAS, CAROL JEAN (MN ARNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:OAS
Suffix:
Gender:F
Credentials:MN ARNP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:JEAN
Other - Last Name:HATHAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MN ARNP
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362
Mailing Address - Country:US
Mailing Address - Phone:360-452-1775
Mailing Address - Fax:360-928-9712
Practice Address - Street 1:113 SO EUNICE ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362
Practice Address - Country:US
Practice Address - Phone:360-460-3836
Practice Address - Fax:360-928-9712
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006082363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA255764255764OtherPREMERA BLUE CROSS
WA4063HAOtherREGENCE BLUE SHIELD
WAG8803905Medicare PIN
WAP61120Medicare UPIN