Healthcare Provider Details

I. General information

NPI: 1013012152
Provider Name (Legal Business Name): PHYLLIS HOLZWORTH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CALIFORNIA AVE SW
SEATTLE WA
98116-3302
US

IV. Provider business mailing address

905 SPRUCE ST STE 300
SEATTLE WA
98104-2474
US

V. Phone/Fax

Practice location:
  • Phone: 206-658-8048
  • Fax: 206-658-8063
Mailing address:
  • Phone: 206-461-6935
  • Fax: 206-461-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30001367
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00078257
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: