Provider Demographics
NPI:1033341359
Name:IRISH, PATI SUTER (ARNP)
Entity Type:Individual
Prefix:
First Name:PATI
Middle Name:SUTER
Last Name:IRISH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT OF VETERANS AFFAIRS
Mailing Address - Street 2:AMERICAN LAKE DIVISION A 123 RED
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-5000
Mailing Address - Country:US
Mailing Address - Phone:253-583-1234
Mailing Address - Fax:253-589-4150
Practice Address - Street 1:DEPT OF VETERANS AFFAIRS
Practice Address - Street 2:AMERICAN LAKE DIVISION A-123 RED
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-583-1234
Practice Address - Fax:253-589-4150
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00174486163W00000X
WAAP60098624363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse