Healthcare Provider Details

I. General information

NPI: 1548213614
Provider Name (Legal Business Name): BARBARA L EISENBERG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MAIN AVE S
NORTH BEND WA
98045
US

IV. Provider business mailing address

13539 NORTHSHIRE RD NW
SEATTLE WA
98177-4033
US

V. Phone/Fax

Practice location:
  • Phone: 425-333-6924
  • Fax: 425-333-6909
Mailing address:
  • Phone: 206-788-6226
  • Fax: 206-363-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005985
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: