Healthcare Provider Details

I. General information

NPI: 1477650802
Provider Name (Legal Business Name): NANCY LEE BARTHOLOMEW ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12040 NE 128TH ST MS 31
KIRKLAND WA
98034-3013
US

IV. Provider business mailing address

PO BOX 34036
SEATTLE WA
98124-1036
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-2789
  • Fax: 425-899-2759
Mailing address:
  • Phone: 425-899-3292
  • Fax: 425-899-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30005344
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberAP30005344
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: