Provider Demographics
NPI:1467083287
Name:GLENNIE, SONIA C (ARNP, MSN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:C
Last Name:GLENNIE
Suffix:
Gender:F
Credentials:ARNP, MSN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 NW 56TH ST APT 406
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4259
Mailing Address - Country:US
Mailing Address - Phone:503-551-4763
Mailing Address - Fax:
Practice Address - Street 1:1221 MADISON ST STE 1020
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1380
Practice Address - Country:US
Practice Address - Phone:206-215-2658
Practice Address - Fax:206-991-2363
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60225256163W00000X
WAAP61019165363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse