Provider Demographics
NPI:1003061722
Name:GALVEZ, DAWN EWING (FNP-C)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:EWING
Last Name:GALVEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S KITSAP BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3709
Mailing Address - Country:US
Mailing Address - Phone:360-744-6275
Mailing Address - Fax:253-201-0490
Practice Address - Street 1:450 S KITSAP BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3709
Practice Address - Country:US
Practice Address - Phone:360-744-6275
Practice Address - Fax:253-201-0490
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3731363LF0000X
WAAP60854090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2111619Medicaid