Healthcare Provider Details

I. General information

NPI: 1548095730
Provider Name (Legal Business Name): EDINA WEDE CARR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19515 N CREEK PKWY STE 202
BOTHELL WA
98011-8200
US

IV. Provider business mailing address

4205 164TH PL SE
BOTHELL WA
98012-5444
US

V. Phone/Fax

Practice location:
  • Phone: 425-443-6496
  • Fax:
Mailing address:
  • Phone: 425-443-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70050542
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61349969
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: