Provider Demographics
NPI:1437749298
Name:SUMNER, WILLIAM RICHARD JR (ARNP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:SUMNER
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W MARINE VIEW DR STE 2010
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98207-0001
Mailing Address - Country:US
Mailing Address - Phone:425-304-4118
Mailing Address - Fax:425-304-4101
Practice Address - Street 1:104 LACEY ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-0001
Practice Address - Country:US
Practice Address - Phone:712-527-4811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60793547163W00000X
NE113978363LF0000X
IAA166252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse