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General NPI Number Information
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NPI Number | 1881787596
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Entity Type | Individual
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Provider Name | ELENA MARIE BOSQUE ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 400 S 43RD ST
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City | RENTON
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State | WA
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Zip | 98055-5714
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Country | US
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Telephone | 425-656-5525
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Fax | 425-656-4228
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Provider Business Mailing Address
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Address Line | PO BOX 430
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City | AUBURN
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State | WA
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Zip | 98071-0430
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Country | US
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Telephone | 425-656-5525
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Fax | 425-656-4228
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | AP30005076
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License Number State | WA
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