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NPI Code Detail

MEDICARE: DESPIERTA PLLC

MEDICARE: DESPIERTA PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist

General Provider Information

NPI Number : 1285597633
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESPIERTA PLLC
Provider Business Mailing Address
First Line : 5275 S BRANDON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2522
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5275 S BRANDON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2522
Country : US
Telephone Number : 206-446-8226
Fax Number :
Authorized Official
Title or Position : OWNER/PROVIDER
Name : ERIC NELSON
Credential : AP
Telephone Number : 206-446-8226
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/11/2025

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Directions to “DESPIERTA PLLC ” Practice Location

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