Healthcare Provider Details

I. General information

NPI: 1346525284
Provider Name (Legal Business Name): BROOKE ANN BUCCI CNM, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PACIFIC AVE STE 501
EVERETT WA
98201-4189
US

IV. Provider business mailing address

PO BOX 60141
SEATTLE WA
98160-0141
US

V. Phone/Fax

Practice location:
  • Phone: 425-683-0500
  • Fax: 425-258-7540
Mailing address:
  • Phone: 240-298-4235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberR144898
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAP61306264
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: