Basic Information
| Provider Information | |||||||||
| NPI: | 1033105036 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | RAMONA | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1115 SE 164TH AVE DEPT 358 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986838004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604142048 | ||||||||
| FaxNumber: | 3605756749 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986323256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606364836 | ||||||||
| FaxNumber: | 3606366792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2005 | ||||||||
| LastUpdateDate: | 06/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | RN00117975 | WA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 363LP0808X | AP30004997 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 8905949 | 01 | WA | CRIME VICTIMS | OTHER | 9624933 | 05 | WA | MEDICAID | P00371420 | 01 | RR MEDICARE | OTHER | 213501 | 05 | OR | MEDICAID |