MEDICARE: JOSEPH GARDNER ARNP

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
1	363LF0000X	Family Nurse Practitioner	AP 60429654	WA

General Provider Information

NPI Number	:	1629409461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH GARDNER ARNP

Provider Business Mailing Address
First Line	:	1511 6TH AVE
Second Line	:	SUITE 360
City	:	SEATTLE
State	:	WA
Zip	:	98101-1759
Country	:	US
Telephone Number	:	206-356-7503
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 6TH AVE
Second Line	:	SUITE 360
City	:	SEATTLE
State	:	WA
Zip	:	98101-1759
Country	:	US
Telephone Number	:	206-356-7503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2013
Last Update Date	:	03/30/2021

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