In Home Primary Care, PLLC
Organization Active NPI Gerontology Nurse Practitioner · Snohomish, WA
NPI 1356469720 · NPPES record last updated Apr 1, 2010
Key facts
- NPI
- 1356469720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- AP30005721 (WA)
- Legal business name
- IN HOME PRIMARY CARE, PLLC
- Practice address
- 127 Avenue a Bay 3
Ste 1 & 2
Snohomish, WA 98290-2962 - Phone
- (360) 863-3657
- Fax
- (360) 863-6295
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Betty A Westfall, MN,ARNP
- Title
- Managing Member
- Phone
- (360) 863-3657
Practitioners 6
-
Barbara L Eisenberg, ARNP
-
Janelle Kay Klein, ARNP
-
Kimberly Ruth Poppe, ARNP
-
Patricia L Rolstad, ARNP
-
Jeniffer Tobon, ARNP
National Provider Directory
Locations
127 Avenue A
Ste 1
Snohomish, WA 98290
Phone (360) 663-3657
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner |
363LG0600X | AP30005721 | WA | Yes |
Addresses
Primary practice location
127 Avenue a Bay 3
Ste 1 & 2
Snohomish, WA 98290-2962
Mailing address
127 Avenue a Bay 3
Ste 1 & 2
Snohomish, WA 98290-2962
Phone (360) 863-3657
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7117237 | Medicaid | WA |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.