Healthcare Provider Details

I. General information

NPI: 1700662111
Provider Name (Legal Business Name): MONICA NICOLE PREDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA NICOLE CASKEY

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5631 3RD AVE NW
SEATTLE WA
98107-2703
US

IV. Provider business mailing address

5631 3RD AVE NW
SEATTLE WA
98107-2703
US

V. Phone/Fax

Practice location:
  • Phone: 425-377-4301
  • Fax: 949-864-3327
Mailing address:
  • Phone: 425-377-4301
  • Fax: 949-864-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61531674
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN00148450
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: