Individual
JAIMIE ALLENE MOGUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1302 COMMERCE AVE, LONGVIEW, WA 98632
(360) 606-4638
Mailing address
21 ORCHARD DR, CATHLAMET, WA 98612-9517
(360) 606-4638
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP61617758
WA
363LF0000X
Family Nurse Practitioner
AP61617758
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61617758
WA
Other
Enumeration date
10/28/2024
Last updated
04/08/2026
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