Healthcare Provider Details

I. General information

NPI: 1316015381
Provider Name (Legal Business Name): MOIRA OPALKA RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12303 NE 130TH LN STE 550
KIRKLAND WA
98034-3041
US

IV. Provider business mailing address

12303 NE 130TH LN STE 550
KIRKLAND WA
98034-3041
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-3224
  • Fax: 425-544-8901
Mailing address:
  • Phone: 425-899-3224
  • Fax: 425-544-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61089224
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: