Healthcare Provider Details

I. General information

NPI: 1043304777
Provider Name (Legal Business Name): SVETLANA MEYERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 37TH AVE S
SEATTLE WA
98118
US

IV. Provider business mailing address

905 SPRUCE ST STE 300
SEATTLE WA
98104
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-6957
  • Fax: 206-461-7810
Mailing address:
  • Phone: 206-461-6935
  • Fax: 206-461-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN00126593
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: