Provider Demographics
NPI:1073945960
Name:DEBORAH SEIDEL ARNP, INC., PS
Entity Type:Organization
Organization Name:DEBORAH SEIDEL ARNP, INC., PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-654-6699
Mailing Address - Street 1:4729 S BRANDON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2357
Mailing Address - Country:US
Mailing Address - Phone:206-654-6699
Mailing Address - Fax:206-523-0590
Practice Address - Street 1:6534 4TH AVE NE
Practice Address - Street 2:SUITE #103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6440
Practice Address - Country:US
Practice Address - Phone:206-654-6699
Practice Address - Fax:206-523-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004064363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty