Provider Demographics
NPI:1518588730
Name:MIENK, SUMMER RACHELLE LOWERY (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:RACHELLE LOWERY
Last Name:MIENK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:RACHELLE
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1902 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1155
Mailing Address - Country:US
Mailing Address - Phone:206-956-9570
Mailing Address - Fax:
Practice Address - Street 1:1902 2ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1155
Practice Address - Country:US
Practice Address - Phone:206-956-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60364139163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health