Healthcare Provider Details

I. General information

NPI: 1962510248
Provider Name (Legal Business Name): CARISSA C. CROSS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARISSA A. ANUAR ARNP

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAP60647411
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60647411
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60647411
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: