Healthcare Provider Details

I. General information

NPI: 1356338834
Provider Name (Legal Business Name): DEBORAH R KEARNES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH R ANDERSON

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 12/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE STE 300
SEATTLE WA
98104-2120
US

IV. Provider business mailing address

PO BOX 3489
SEATTLE WA
98114-3489
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-9500
  • Fax: 206-386-9605
Mailing address:
  • Phone: 206-386-9500
  • Fax: 206-386-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30000066
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN00048986
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: