Provider Demographics
NPI:1457544249
Name:OXENFORD, EVELYN KVERNDAL (ARNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:KVERNDAL
Last Name:OXENFORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:KVERNDAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-671-4402
Practice Address - Fax:360-671-9463
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00172104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9653924Medicaid
5797OXOtherREGENCE
WA0237831OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA5739OXOtherREGENCE
WA8947980OtherL&I CRIME VICTIMS