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General NPI Number Information
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NPI Number | 1598272155
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Entity Type | Organization
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Legal Business Name | NOVARI PRIMARY CARE LLC
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 4686 POINTES DR STE 219
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City | MUKILTEO
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State | WA
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Zip | 98275
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Country | US
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Telephone | 425-405-8089
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Fax | 425-426-2277
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Provider Business Mailing Address
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Address Line | 4686 POINTES DR STE 219
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City | MUKILTEO
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State | WA
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Zip | 98275-6038
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Country | US
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Telephone | 425-405-8089
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Fax | 425-426-2277
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | KARLA CHANEY BALLEW
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Credential | ARNP
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Telephone | 425-405-8089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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