Healthcare Provider Details

I. General information

NPI: 1073189817
Provider Name (Legal Business Name): EMILY BAVASI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

858 NW 90TH ST
SEATTLE WA
98117-3258
US

IV. Provider business mailing address

900 PACIFIC AVE STE 501
EVERETT WA
98201-4189
US

V. Phone/Fax

Practice location:
  • Phone: 206-419-4063
  • Fax:
Mailing address:
  • Phone: 425-303-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN60282751
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP61351969
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: