Healthcare Provider Details

I. General information

NPI: 1609081249
Provider Name (Legal Business Name): RONDA ANN BROWN WADE MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4027 HOYT AVE
EVERETT WA
98201-4920
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-304-8476
  • Fax:
Mailing address:
  • Phone: 425-304-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60699324
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5046
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: