Provider Demographics
NPI:1306128764
Name:MAGRAM, ARIEL JANE (RN)
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:JANE
Last Name:MAGRAM
Suffix:
Gender:F
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:PO BOX 9825
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-8825
Mailing Address - Country:US
Mailing Address - Phone:564-397-8000
Mailing Address - Fax:564-397-8110
Practice Address - Street 1:1601 E 4TH PLAIN BLVD BLDG 17, 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3753
Practice Address - Country:US
Practice Address - Phone:564-397-8000
Practice Address - Fax:564-397-8110
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60792955171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator