Healthcare Provider Details

I. General information

NPI: 1427393826
Provider Name (Legal Business Name): MARY K SYKES RN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 59TH AVE SW ALKI ELEMENTARY SCHOOL
SEATTLE WA
98116-2820
US

IV. Provider business mailing address

3010 59TH AVE SW ALKI ELEMENTARY SCHOOL
SEATTLE WA
98116-2820
US

V. Phone/Fax

Practice location:
  • Phone: 206-252-9050
  • Fax: 206-743-3103
Mailing address:
  • Phone: 206-252-9050
  • Fax: 206-743-3103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN60234746
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: