Provider Demographics
NPI:1275108359
Name:ERVIN, NATALIE RAE (ARNP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:RAE
Last Name:ERVIN
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 1:27203 216TH AVE SE STE D
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-3274
Mailing Address - Country:US
Mailing Address - Phone:425-690-3425
Mailing Address - Fax:425-690-9425
Practice Address - Street 1:27203 216TH AVE SE STE D
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-3274
Practice Address - Country:US
Practice Address - Phone:425-690-3425
Practice Address - Fax:425-690-9425
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61186256363LF0000X
WAAP51186256363L00000X
WARN60687084363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily