Provider Demographics
NPI:1164826350
Name:WATTLES, ERIN MICHELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:WATTLES
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 1:17700 SE 272ND ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4951
Mailing Address - Country:US
Mailing Address - Phone:253-372-7155
Mailing Address - Fax:
Practice Address - Street 1:17700 SE 272ND ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4951
Practice Address - Country:US
Practice Address - Phone:253-372-7155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-16
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60512131363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics