Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP30005895 | WA |
NPI | 1013031475 |
---|---|
Provider Name | Ms. Darcy D King |
First Address | Lake Forest Park, WA 98155-1415 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4300855 | (05) | MT |
806605900 | (05) | ID |
9630922 | (05) | WA |
NP339WA | (05) | AK |
P89250 | (02) |