Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP30007552 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP30007552 | WA |
NPI | 1497825673 |
---|---|
Provider Name | Colleen Mulvihill Pacem |
First Address | Seattle, WA 98124-1036 |
Second Address | Sammamish, WA 98074-7256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 16/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9653809 | (05) | WA |