=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861583445
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VALERIE F QUEST PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2006
-----------------------------------------------------
Last Update Date | 05/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 S 43RD ST ER DEPT
-----------------------------------------------------
City | RENTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98055-5714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-656-4255
-----------------------------------------------------
Fax | 425-656-4003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8009 S 180TH ST SUITE 103
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98032-1042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-656-4255
-----------------------------------------------------
Fax | 425-656-4003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | PA10004853
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------