Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP61080970 | WA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP61080970 | WA |
NPI | 1346615895 |
---|---|
Provider Name | Vincent Michael Depassio |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2015 |
Last Update Date | 19/10/2021 |