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General NPI Number Information
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NPI Number | 1962688788
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Entity Type | Individual
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Provider Name | ELLEN MARIE SUNDSTROM RN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | ELEANOR HEALTH SEATTLE CLINIC 1120 E TERRACE STREET SUITE 100
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City | SEATTLE
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State | WA
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Zip | 98122-7405
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Country | US
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Telephone | 206-594-1065
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Fax | 833-654-0691
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Provider Business Mailing Address
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Address Line | 10011 BRIDGEPORT WAY SE SUITE 1500 PMB 201
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City | LAKEWOOD
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State | WA
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Zip | 98499-2332
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Country | US
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Telephone | 214-686-3588
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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 | AP116342
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License Number State | TX
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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 | 219835
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201907446NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 133766
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60650034
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License Number State | WA
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