Healthcare Provider Details

I. General information

NPI: 1013322114
Provider Name (Legal Business Name): DOREEN YUMANG-ROSS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 FEDERAL AVE
EVERETT WA
98203-2132
US

IV. Provider business mailing address

4526 FEDERAL AVE
EVERETT WA
98203-2132
US

V. Phone/Fax

Practice location:
  • Phone: 425-349-6200
  • Fax:
Mailing address:
  • Phone: 425-349-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60471342
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberN360477477
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberN360477477
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60471342
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: