Provider Demographics
NPI:1003287749
Name:BRANTLEY-DALGLISH, ARIEL (CNM)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:BRANTLEY-DALGLISH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4905
Mailing Address - Country:US
Mailing Address - Phone:425-690-3480
Mailing Address - Fax:425-690-9480
Practice Address - Street 1:1 E MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4905
Practice Address - Country:US
Practice Address - Phone:425-690-3480
Practice Address - Fax:425-690-9480
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61088584163W00000X
OR201407145RN163W00000X
OR201606806NP-PP367A00000X
WAAP61088603367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500713679Medicaid
WA2162681Medicaid