MEDICARE: CIARA NICOLE ATABEYGI 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	363L00000X	Nurse Practitioner	AP60315932	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP60315932	OTHER	WA	STATE LICENSE

General Provider Information

NPI Number	:	1861737389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA NICOLE ATABEYGI ARNP

Provider Business Mailing Address
First Line	:	150 DENNIS ST SW
Second Line	:	STE A
City	:	TUMWATER
State	:	WA
Zip	:	98501-5459
Country	:	US
Telephone Number	:	360-754-6367
Fax Number	:	360-754-6429

Provider Business Practice Location Address
First Line	:	150 DENNIS ST SW STE A
Second Line	:
City	:	TUMWATER
State	:	WA
Zip	:	98501-5486
Country	:	US
Telephone Number	:	360-754-6367
Fax Number	:	360-754-6429

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

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	03/07/2023

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