Provider Demographics
NPI:1417946955
Name:ADAMS, GAYLENE ANN (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:GAYLENE
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4140 FACTORIA BLVD SE
Mailing Address - Street 2:STE A
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5261
Mailing Address - Country:US
Mailing Address - Phone:425-644-2273
Mailing Address - Fax:425-644-7318
Practice Address - Street 1:4140 FACTORIA BLVD SE
Practice Address - Street 2:STE A
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5261
Practice Address - Country:US
Practice Address - Phone:425-644-2273
Practice Address - Fax:425-644-7318
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily