Provider Demographics
NPI:1427324045
Name:SHULL, CATHERINE YVONNE (APRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:YVONNE
Last Name:SHULL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 N LAVENTURE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2766
Mailing Address - Country:US
Mailing Address - Phone:360-542-8900
Mailing Address - Fax:360-542-8796
Practice Address - Street 1:1400 N LAVENTURE RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2766
Practice Address - Country:US
Practice Address - Phone:360-542-8900
Practice Address - Fax:360-542-8166
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60737311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily