Healthcare Provider Details

I. General information

NPI: 1528336021
Provider Name (Legal Business Name): MARISSA LEE ABRAHAMS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISSA LEE NEROUTSOS

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W GALER ST
SEATTLE WA
98119-3332
US

IV. Provider business mailing address

1549 NW 90TH ST UNIT A
SEATTLE WA
98117-2724
US

V. Phone/Fax

Practice location:
  • Phone: 347-460-1407
  • Fax: 347-333-6645
Mailing address:
  • Phone: 206-595-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61376064
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61376077
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402689
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number646146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: