Provider Demographics
NPI:1891484655
Name:WASH, DIANA MARCELA (RN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARCELA
Last Name:WASH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARCELA
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:708 SW GRANT WAY
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-1500
Mailing Address - Country:US
Mailing Address - Phone:917-825-9104
Mailing Address - Fax:
Practice Address - Street 1:16411 NE OREGON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-5857
Practice Address - Country:US
Practice Address - Phone:503-334-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201903187RN163WC1600X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development