Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60607514 | WA |
NPI | 1003287434 |
---|---|
Provider Name | Danielle Renee Puri |
First Address | Seattle, WA 98112-5251 |
Second Address | Kent, WA 98032-5852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2015 |
Last Update Date | 20/12/2017 |