Provider Demographics
NPI:1174726335
Name:CHAMLEE, DEENA M (CNM)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:M
Last Name:CHAMLEE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ELAN MIDWIFERY PO BOX 821750
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682
Mailing Address - Country:US
Mailing Address - Phone:360-719-2171
Mailing Address - Fax:360-719-2172
Practice Address - Street 1:11801 NE 65TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-5527
Practice Address - Country:US
Practice Address - Phone:360-719-2171
Practice Address - Fax:360-719-2172
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200150100NP176B00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OROR268678Medicaid
WA1032697Medicaid