Provider Demographics
NPI:1285035105
Name:DARROCH, DAWN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:DARROCH
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 1:742 LEBO BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3325
Mailing Address - Country:US
Mailing Address - Phone:360-744-4950
Mailing Address - Fax:253-426-6344
Practice Address - Street 1:742 LEBO BLVD STE A
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3325
Practice Address - Country:US
Practice Address - Phone:360-744-4950
Practice Address - Fax:253-426-6344
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60506153363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2040445Medicaid
WAAP60506153OtherSTATE LICENSE