Provider Demographics
NPI:1508056219
Name:BROOKING, BETTY J (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:J
Last Name:BROOKING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:J
Other - Last Name:FRITZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1738 S DAWSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2363
Mailing Address - Country:US
Mailing Address - Phone:206-763-7007
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00171978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse