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General NPI Number Information
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NPI Number | 1730588096
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Entity Type | Individual
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Provider Name | AARON MARCUS IVAN DRUCK FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 3845 BEACH DR SW APT 1
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City | SEATTLE
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State | WA
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Zip | 98116-3521
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Country | US
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Telephone | 720-393-9032
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Fax |
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Provider Business Mailing Address
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Address Line | 3845 BEACH DR SW APT 1
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City | SEATTLE
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State | WA
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Zip | 98116-3521
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Country | US
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Telephone | 720-393-9032
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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 | 60474380
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-02518
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License Number State | NM
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