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General NPI Number Information
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NPI Number | 1508873449
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Entity Type | Individual
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Provider Name | PATRICIA ANN DERYKE ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 1560 N 115TH ST # ST-201
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City | SEATTLE
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State | WA
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Zip | 98133-8414
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Country | US
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Telephone | 206-368-1244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33450
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City | SEATTLE
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State | WA
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Zip | 98133-0450
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Country | US
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Telephone | 206-368-1244
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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 | AP30006520
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License Number State | WA
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