Provider Demographics
NPI:1215039854
Name:DRAKE, JENNIFER CHRISTINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:DRAKE
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 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:4240 AUBURN WAY N
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-1311
Practice Address - Country:US
Practice Address - Phone:253-876-8900
Practice Address - Fax:253-876-8910
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP3006226363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9635616Medicaid
WAP87510Medicare UPIN