Provider Demographics
NPI:1245291541
Name:EINERSON, CHERYL E (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:E
Last Name:EINERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:E
Other - Last Name:ARNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13206 NE 227TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-4203
Mailing Address - Country:US
Mailing Address - Phone:306-607-9880
Mailing Address - Fax:360-892-1228
Practice Address - Street 1:4421 NE ST JOHNS RD STE F
Practice Address - Street 2:FAMILY CARE & URGENT MEDICAL CLINIC
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-2573
Practice Address - Country:US
Practice Address - Phone:360-695-9922
Practice Address - Fax:360-695-1310
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200050020NP363L00000X
WAAP30005665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8871006OtherMEDICARE
WAG8871006Medicare PIN
OR113583Medicare ID - Type Unspecified
WAG8871006OtherMEDICARE