Provider Demographics
NPI:1073912242
Name:SIRIWARDANA, NADEE M (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NADEE
Middle Name:M
Last Name:SIRIWARDANA
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 N MAMER RD STE B100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-3712
Mailing Address - Country:US
Mailing Address - Phone:509-863-9779
Mailing Address - Fax:509-863-9608
Practice Address - Street 1:1620 N MAMER RD STE B100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-3712
Practice Address - Country:US
Practice Address - Phone:509-863-9779
Practice Address - Fax:530-863-9608
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61087292363LP0808X
NH072349-23363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health