Healthcare Provider Details

I. General information

NPI: 1366832347
Provider Name (Legal Business Name): BREA ADELE SEABURG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. BREA ADELE FLUETSCH

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 08/18/2017
Certification Date:
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 3649
SPOKANE WA
99220-3649
US

V. Phone/Fax

Practice location:
  • Phone: 360-791-3687
  • Fax:
Mailing address:
  • Phone: 509-342-3758
  • Fax: 509-342-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP 60495837
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: