Healthcare Provider Details

I. General information

NPI: 1093167934
Provider Name (Legal Business Name): ERIKA LEE FRYE PESCHEL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2016
Last Update Date: 07/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE STE 110
BOTHELL WA
98021-4412
US

IV. Provider business mailing address

12040 NE 128TH ST
KIRKLAND WA
98034-3013
US

V. Phone/Fax

Practice location:
  • Phone: 425-488-4988
  • Fax:
Mailing address:
  • Phone: 425-899-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP 60672852
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: