Healthcare Provider Details

I. General information

NPI: 1801055454
Provider Name (Legal Business Name): CATHERINE ANNE GRUPP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2008
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5413 MERIDIAN AVE N STE A
SEATTLE WA
98103-6166
US

IV. Provider business mailing address

5413 MERIDIAN AVE N STE A
SEATTLE WA
98103-6166
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-8287
  • Fax: 206-588-2466
Mailing address:
  • Phone: 206-718-4869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberAP30007880
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: