Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | AP6094553 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP6094553 | WA |
NPI | 1386293561 |
---|---|
Provider Name | Emily Jane Lippold |
First Address | Seattle, WA 98112-4093 |
Second Address | Seattle, WA 98104-2697 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2019 |
Last Update Date | 20/12/2019 |