Healthcare Provider Details

I. General information

NPI: 1598799546
Provider Name (Legal Business Name): PAUL D. FOUCAULT ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 SOUTH COLUMBIAN WAY SEATTLE VETERANS ADMINISTRATION MEDICAL CENTER
SEATTLE WA
98108-1597
US

IV. Provider business mailing address

PO BOX 24366
SEATTLE WA
98124-0366
US

V. Phone/Fax

Practice location:
  • Phone: 206-768-5468
  • Fax:
Mailing address:
  • Phone: 206-598-0502
  • Fax: 206-598-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30006276
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30006276
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00133865
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: