Provider Demographics
NPI:1780702399
Name:PASCUA, NANCY CARR (ARNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:CARR
Last Name:PASCUA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-1845
Mailing Address - Country:US
Mailing Address - Phone:360-397-8484
Mailing Address - Fax:360-993-3047
Practice Address - Street 1:1601 NE FOURTH PLAIN BLVD. BLDG 17, S
Practice Address - Street 2:SUITE B222
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661
Practice Address - Country:US
Practice Address - Phone:360-397-8484
Practice Address - Fax:360-993-3047
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166024163W00000X
WAAP60268409363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse