Provider Demographics
NPI:1831402080
Name:ADAMES, AUDREY QUINN (LPN)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:QUINN
Last Name:ADAMES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-5249
Mailing Address - Country:US
Mailing Address - Phone:360-254-2816
Mailing Address - Fax:
Practice Address - Street 1:200 NW 107TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-5249
Practice Address - Country:US
Practice Address - Phone:360-254-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201030059LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse