Provider Demographics
NPI:1497264311
Name:GEORGE, GINNY (ARNP)
Entity Type:Individual
Prefix:MS
First Name:GINNY
Middle Name:
Last Name:GEORGE
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 1:108 194TH PL SW
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5092
Mailing Address - Country:US
Mailing Address - Phone:502-494-9949
Mailing Address - Fax:
Practice Address - Street 1:125 130TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:425-385-2263
Practice Address - Fax:425-224-8297
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9340866363LA2100X
WAAP60803554363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care