Organization · Type 2 NPI

Providence Health & Services-Wa

Nurse Practitioner · Everett, WA

NPI number 1164673554 Active

Practice location

1509 California St
Everett, WA 98201-3540

Fax (425) 259-5831

Mailing address

PO Box 31001-4110
Pasadena, CA 91110-4110

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1164673554

Providence Health & Services-Wa's National Provider Identifier is 1164673554, issued on Oct 4, 2008. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Everett, WA. The record was last updated on May 7, 2025.