Healthcare Provider Details

I. General information

NPI: 1265542609
Provider Name (Legal Business Name): JEAN SIGEL EMANUEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEAN LOUISE EMANUEL RN

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15436 BEL RED RD STE 100
REDMOND WA
98052-5536
US

IV. Provider business mailing address

15436 BEL RED RD STE 100
REDMOND WA
98052-5536
US

V. Phone/Fax

Practice location:
  • Phone: 425-644-4100
  • Fax: 425-644-4101
Mailing address:
  • Phone: 425-644-4100
  • Fax: 425-644-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRC00024506
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00051122
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: