Healthcare Provider Details

I. General information

NPI: 1609350453
Provider Name (Legal Business Name): VIRGINIA A ARNOLD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 03/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 POST ALY
SEATTLE WA
98101-1074
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-728-4143
  • Fax: 206-956-1018
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-762-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60867435
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP60867435
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: