Provider Demographics
NPI:1558136168
Name:NASH, MICHAEL A (RN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:NASH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37400 NE AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:YACOLT
Mailing Address - State:WA
Mailing Address - Zip Code:98675-4835
Mailing Address - Country:US
Mailing Address - Phone:360-216-3788
Mailing Address - Fax:
Practice Address - Street 1:37400 NE AMBOY RD
Practice Address - Street 2:
Practice Address - City:YACOLT
Practice Address - State:WA
Practice Address - Zip Code:98675-4835
Practice Address - Country:US
Practice Address - Phone:360-216-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA200641334RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health