Healthcare Provider Details

I. General information

NPI: 1558401687
Provider Name (Legal Business Name): SILVIA FRADKIN ARNP PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6512 20TH STREET CT W STE C
FIRCREST WA
98466-6212
US

IV. Provider business mailing address

2025 NARROWS VIEW CIR NW APT D134
GIG HARBOR WA
98335-6815
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-0295
  • Fax: 253-565-5899
Mailing address:
  • Phone: 253-514-8562
  • Fax: 253-565-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. SILVIA FRADKININ
Title or Position: CHIEF OFFICER
Credential: ARNP
Phone: 253-459-0295