Provider Demographics
NPI:1356118061
Name:EASTERLY, DARLENA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:DARLENA
Middle Name:MARIE
Last Name:EASTERLY
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 1:13210 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2501
Mailing Address - Country:US
Mailing Address - Phone:503-421-0403
Mailing Address - Fax:
Practice Address - Street 1:13210 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2501
Practice Address - Country:US
Practice Address - Phone:503-421-0403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00139179163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health