Provider Demographics
NPI:1639266000
Name:CASE, DAWN R (ARNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:R
Last Name:CASE
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:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:1221 MADISON ST FL 2
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3588
Practice Address - Country:US
Practice Address - Phone:206-386-2323
Practice Address - Fax:206-568-7043
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61155478363L00000X
WARN61150472163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000500865OtherANTHEM BC&BS
IN000000971123OtherBCBS HEMATOLOGY
IN200842990Medicaid
IN000000971123OtherBCBS HEMATOLOGY
MIMC1522184OtherDEA
IN71002242BOtherCSR
IN000000971124OtherBCBS ONCOLOGY
IN200842990Medicaid
IN000000971124OtherBCBS ONCOLOGY
IN000000500865OtherANTHEM BC&BS
INMC1508831OtherDEA