Provider Demographics
NPI:1033399944
Name:COUGHLIN, DEBORAH ANN (ARNP: AP30007936)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:ARNP: AP30007936
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 M ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6755
Mailing Address - Country:US
Mailing Address - Phone:253-735-2777
Mailing Address - Fax:253-735-4153
Practice Address - Street 1:1340 M ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6755
Practice Address - Country:US
Practice Address - Phone:253-735-2777
Practice Address - Fax:253-735-4153
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily