Provider Demographics
NPI:1497040331
Name:ULMER, ASHLEY BOOTH (MSN, CNM, ARNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BOOTH
Last Name:ULMER
Suffix:
Gender:F
Credentials:MSN, CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 SE MAIN ST STE 3001
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2458
Mailing Address - Country:US
Mailing Address - Phone:503-261-4423
Mailing Address - Fax:503-261-4424
Practice Address - Street 1:10101 SE MAIN ST STE 3001
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2458
Practice Address - Country:US
Practice Address - Phone:503-261-4423
Practice Address - Fax:503-261-4424
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00174879163W00000X
CAAPRN1936367A00000X
WAAP60268381367A00000X
FLARNP 9236524367A00000X
OR201500124NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500680783Medicaid
ORR231394OtherMEDICARE
ORR179321Medicare PIN
ORR179532Medicare PIN