Provider Demographics
NPI:1417011503
Name:GREILING, SUE A (ARNP)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:GREILING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:SALAJA GREILING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:171 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3749
Mailing Address - Country:US
Mailing Address - Phone:206-352-3728
Mailing Address - Fax:
Practice Address - Street 1:9575 ETHAN WADE WAY SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9577
Practice Address - Country:US
Practice Address - Phone:425-831-2321
Practice Address - Fax:425-831-2361
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005347363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9628769Medicaid
WA0198114OtherLABOR AND INDUSTRIES
WA9628769Medicaid
P24914Medicare UPIN