Healthcare Provider Details

I. General information

NPI: 1851899041
Provider Name (Legal Business Name): WHITNEY D HOGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15580 3RD AVE SW
BURIEN WA
98166-4565
US

IV. Provider business mailing address

15580 3RD AVE SW
BURIEN WA
98166-4565
US

V. Phone/Fax

Practice location:
  • Phone: 206-453-4215
  • Fax: 206-453-4215
Mailing address:
  • Phone: 206-453-4215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60828819
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60291285
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: