Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP60798029 | WA |
NPI | 1063943249 |
---|---|
Provider Name | Alix Vandeventer Quinn |
First Address | Seattle, WA 98122-2959 |
Second Address | Bellevue, WA 98007-4116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2017 |
Last Update Date | 04/05/2020 |