Provider Demographics
NPI:1154047801
Name:CEDAR, ASHLEY ROSE (ARNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:CEDAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ROSE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4894 K AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51037-7012
Mailing Address - Country:US
Mailing Address - Phone:712-540-8386
Mailing Address - Fax:
Practice Address - Street 1:101 ELLIOTT AVE W STE 500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4292
Practice Address - Country:US
Practice Address - Phone:206-708-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG171432363LP0808X
WAAP61367344363LP0808X
WARN61365832363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health