Provider Demographics
NPI:1578722344
Name:NDUKA, ROSEMARY (ARNP)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:NDUKA
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 1:3625 S CLOVERDALE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4529
Mailing Address - Country:US
Mailing Address - Phone:206-444-7800
Mailing Address - Fax:
Practice Address - Street 1:6100 SOUTHCENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-5714
Practice Address - Country:US
Practice Address - Phone:206-444-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60014569363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health