MEDICARE: ESME THERESE RODDY

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61608112	WA

General Provider Information

NPI Number	:	1710552450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESME THERESE RODDY

Provider Business Mailing Address
First Line	:	1618 S LANE ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2829
Country	:	US
Telephone Number	:	206-464-1570
Fax Number	:

Provider Business Practice Location Address
First Line	:	1618 S LANE ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2829
Country	:	US
Telephone Number	:	206-464-1570
Fax Number	:	206-895-4977

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	03/02/2026

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Directions to “ ESME THERESE RODDY ” Practice Location

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