MEDICARE: MS. EILEEN PATRICIA OKEEFFE 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	AP30001774	WA
2	363L00000X	Nurse Practitioner	AP30001774	WA
3	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	AP30001774	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080124875	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	114285	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1881677060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EILEEN PATRICIA OKEEFFE ARNP

Provider Business Mailing Address
First Line	:	12910 TOTEM LAKE BLVD NE STE 102
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98034-2901
Country	:	US
Telephone Number	:	425-899-4455
Fax Number	:	425-899-4434

Provider Business Practice Location Address
First Line	:	12910 TOTEM LAKE BLVD NE STE 102
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98034-2901
Country	:	US
Telephone Number	:	425-899-4455
Fax Number	:	425-899-4434

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	10/03/2013

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