Healthcare Provider Details

I. General information

NPI: 1750446100
Provider Name (Legal Business Name): BARBARA JOSEPHINE ENSIGN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 N 45TH ST
SEATTLE WA
98103-6701
US

IV. Provider business mailing address

905 SPRUCE ST STE 300
SEATTLE WA
98104-2474
US

V. Phone/Fax

Practice location:
  • Phone: 206-633-3350
  • Fax: 206-633-3113
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30003626
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: