Healthcare Provider Details

I. General information

NPI: 1487742227
Provider Name (Legal Business Name): MARIE ZORNES CRNFA, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE RASMUSSEN

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34509 9TH AVE S STE 204
FEDERAL WAY WA
98003-8708
US

IV. Provider business mailing address

34509 9TH AVE S STE 204
FEDERAL WAY WA
98003-8708
US

V. Phone/Fax

Practice location:
  • Phone: 253-835-5510
  • Fax: 253-835-5511
Mailing address:
  • Phone: 253-835-5510
  • Fax: 253-835-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN00090874
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60318764
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: