Provider Demographics
NPI:1548429327
Name:THOMPSON, PRISCILLA GRACE (ARNP, CNM)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:GRACE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:OSBORN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP, CNM
Mailing Address - Street 1:6722 N WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4153
Mailing Address - Country:US
Mailing Address - Phone:509-467-3820
Mailing Address - Fax:
Practice Address - Street 1:2659 N ASH ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-3606
Practice Address - Country:US
Practice Address - Phone:509-327-0701
Practice Address - Fax:509-324-3669
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00037353163W00000X
WAAP30003848363L00000X
WA4547367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife