Provider Demographics
NPI:1114085164
Name:WHITEHORN, SAIDEE M (ARNP)
Entity Type:Individual
Prefix:
First Name:SAIDEE
Middle Name:M
Last Name:WHITEHORN
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 1:172 NW 73RD ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4851
Mailing Address - Country:US
Mailing Address - Phone:206-783-6505
Mailing Address - Fax:253-382-2091
Practice Address - Street 1:6534 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6440
Practice Address - Country:US
Practice Address - Phone:206-783-6505
Practice Address - Fax:253-382-2091
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003777363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6355WHOtherREGENCE
WA6355WHOtherREGENCE
WAP57881Medicare UPIN