Healthcare Provider Details

I. General information

NPI: 1053128074
Provider Name (Legal Business Name): AUDREY BRETON DNP, ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 12TH AVE
SEATTLE WA
98122-4411
US

IV. Provider business mailing address

901 12TH AVE
SEATTLE WA
98122-4411
US

V. Phone/Fax

Practice location:
  • Phone: 206-296-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70112873-NP
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number61349973
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: