Provider Demographics
NPI:1619597036
Name:FRIED, EMILY JEAN (DNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:FRIED
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-3427
Mailing Address - Country:US
Mailing Address - Phone:360-678-2273
Mailing Address - Fax:
Practice Address - Street 1:311 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3427
Practice Address - Country:US
Practice Address - Phone:360-678-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-26
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60579375163W00000X
WAAP61141519363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse