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General NPI Number Information
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NPI Number | 1164695102
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Entity Type | Individual
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Provider Name | MARIANNA BAGHDASARYAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 21601 76TH AVE W
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City | EDMONDS
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State | WA
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Zip | 98026-7507
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Country | US
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Telephone | 425-640-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 12706 NE 197TH PL
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City | BOTHELL
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State | WA
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Zip | 98011-2555
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Country | US
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Telephone | 425-330-8122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60622644
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00165121
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License Number State | WA
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