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General NPI Number Information
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NPI Number | 1386693232
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Entity Type | Individual
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Provider Name | PAMELA V LUTTRELL ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 10/13/2020
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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 | 253-426-4604
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Fax | 253-426-4601
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Provider Business Mailing Address
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Address Line | PO BOX 25608
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City | SALT LAKE CITY
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State | UT
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Zip | 84125-0608
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Country | US
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Telephone | 206-320-4476
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Fax | 206-568-7043
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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 | AP30005363
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License Number State | WA
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