Healthcare Provider Details

I. General information

NPI: 1184969925
Provider Name (Legal Business Name): ANDREA MARIE VALDEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2012
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 25TH AVE NE STE 120
SEATTLE WA
98105-4107
US

IV. Provider business mailing address

4909 25TH AVE NE STE 120
SEATTLE WA
98105-4107
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-8080
  • Fax: 206-987-8081
Mailing address:
  • Phone: 206-987-8080
  • Fax: 206-987-8081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00156957
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60297384
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: