Provider Demographics
NPI:1093847006
Name:GRIFFING, DEBORAH REYNOLDS (ARNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:REYNOLDS
Last Name:GRIFFING
Suffix:
Gender:F
Credentials:ARNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 84TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1654
Mailing Address - Country:US
Mailing Address - Phone:425-451-4773
Mailing Address - Fax:425-451-2509
Practice Address - Street 1:1715 114TH AVE SE
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6945
Practice Address - Country:US
Practice Address - Phone:425-688-8949
Practice Address - Fax:425-451-2509
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily