Healthcare Provider Details

I. General information

NPI: 1114241171
Provider Name (Legal Business Name): MARJORIE ALLYN BRIDGES RNC ARNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 03/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 116TH AVE NE
BELLEVUE WA
98004-4604
US

IV. Provider business mailing address

985 SE SYMMONS PL
NORTH BEND WA
98045-9377
US

V. Phone/Fax

Practice location:
  • Phone: 425-688-5000
  • Fax:
Mailing address:
  • Phone: 425-888-5335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP.60138152-NP
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP.60138152-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: