Provider Demographics
NPI:1154109064
Name:LUNDELL, ASHLEY RAE (RN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:LUNDELL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18710 E 13TH CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-8699
Mailing Address - Country:US
Mailing Address - Phone:850-516-7502
Mailing Address - Fax:
Practice Address - Street 1:18710 E 13TH CT
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99016-8699
Practice Address - Country:US
Practice Address - Phone:850-516-7502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61086647163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator