Provider Demographics
NPI:1164450854
Name:SPIEKER, EVELYN (MN, ARNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:SPIEKER
Suffix:
Gender:F
Credentials:MN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 SW 43RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4803
Mailing Address - Country:US
Mailing Address - Phone:425-271-4910
Mailing Address - Fax:425-264-1041
Practice Address - Street 1:1412 SW 43RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4803
Practice Address - Country:US
Practice Address - Phone:425-271-4910
Practice Address - Fax:425-264-1041
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006300363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9637364Medicaid
WA8864571Medicare PIN
WA9637364Medicaid
WAQ46491Medicare UPIN