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NPI Code Detail

MEDICARE: BETH STEPHENIE LIGHT ARNP

MEDICARE: BETH STEPHENIE LIGHT ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP30004151WA

General Provider Information

NPI Number : 1023226354
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH STEPHENIE LIGHT ARNP
Provider Business Mailing Address
First Line : 1431 NEWPORT WAY
Second Line :
City : SEATTLE
State : WA
Zip : 98122-3559
Country : US
Telephone Number : 206-329-7546
Fax Number :
Provider Business Practice Location Address
First Line : 3013 S MOUNT BAKER BLVD
Second Line :
City : SEATTLE
State : WA
Zip : 98144-6139
Country : US
Telephone Number : 206-326-2750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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