Healthcare Provider Details
I. General information
NPI: 1265153142
Provider Name (Legal Business Name): ERIN LILLIAN YORK BANNON DNP, ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2022
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23320 HIGHWAY 99
EDMONDS WA
98026-8744
US
IV. Provider business mailing address
23320 HIGHWAY 99
EDMONDS WA
98026-8744
US
V. Phone/Fax
- Phone: 425-789-3789
- Fax:
- Phone: 425-789-3789
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | ARNP.AP.70002999-NP |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN60486143 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: