Healthcare Provider Details

I. General information

NPI: 1720129232
Provider Name (Legal Business Name): DIAN ALICE CHASE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 RAINIER AVE S
SEATTLE WA
98118-5569
US

IV. Provider business mailing address

1200 12TH AVE S STE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-548-5850
  • Fax:
Mailing address:
  • Phone: 206-548-3058
  • Fax: 206-824-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007548
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: