MEDICARE: MS. CYNTHIA GRACE MEINECKE 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
1	163W00000X	Registered Nurse	RN00105947	WA
2	363LF0000X	Family Nurse Practitioner	AP30005976	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0187756	OTHER	WA	LABOR & INDUSTRY

General Provider Information

NPI Number	:	1215939921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA GRACE MEINECKE ARNP

Provider Business Mailing Address
First Line	:	1021 163RD AVE SE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-5032
Country	:	US
Telephone Number	:	425-457-0761
Fax Number	:	425-641-7378

Provider Business Practice Location Address
First Line	:	1021 163RD AVE SE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-5032
Country	:	US
Telephone Number	:	425-457-0761
Fax Number	:	425-641-7378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	03/07/2023

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