Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP30003061 | WA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP30003061 | WA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP30003061 | WA |
NPI | 1043279623 |
---|---|
Provider Name | Patricia L Rolstad |
First Address | Seattle, WA 98109-6241 |
Second Address | Seattle, WA 98109-6241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9624164 | (05) | WA |
S67312 | (02) |