Provider Demographics
NPI:1639365901
Name:MCHUGH, DEIDRE ANNE (DNP, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:DEIDRE
Middle Name:ANNE
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:DR
Other - First Name:DEIDRE
Other - Middle Name:ANNE
Other - Last Name:BERENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1402 E CHERRY ST APT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4500
Mailing Address - Country:US
Mailing Address - Phone:206-323-1768
Mailing Address - Fax:206-323-2184
Practice Address - Street 1:1216 PINE ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-323-1768
Practice Address - Fax:206-323-2184
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60228496363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60228496OtherWASHINGTON STATE DEPARTMENT OF HEALTH
OR200750087NPOtherOREGON NURSING LICENSE