Healthcare Provider Details

I. General information

NPI: 1952529687
Provider Name (Legal Business Name): PATRICIA NAGOURNEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 N BROADWAY
EVERETT WA
98201-1405
US

IV. Provider business mailing address

2414 SW ANDOVER ST D-120
SEATTLE WA
98106-1153
US

V. Phone/Fax

Practice location:
  • Phone: 425-493-5800
  • Fax: 425-493-5801
Mailing address:
  • Phone: 425-493-5800
  • Fax: 425-493-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN00042428
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP30004203
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: