Healthcare Provider Details

I. General information

NPI: 1881677060
Provider Name (Legal Business Name): EILEEN PATRICIA OKEEFFE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12910 TOTEM LAKE BLVD NE STE 102
KIRKLAND WA
98034-2901
US

IV. Provider business mailing address

12910 TOTEM LAKE BLVD NE STE 102
KIRKLAND WA
98034-2901
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-4455
  • Fax: 425-899-4434
Mailing address:
  • Phone: 425-899-4455
  • Fax: 425-899-4434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30001774
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30001774
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP30001774
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: