Provider Demographics
NPI:1669465027
Name:BJELETICH, BARBARA J (MSN, FNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:BJELETICH
Suffix:
Gender:F
Credentials:MSN, FNP
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 24366
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0366
Mailing Address - Country:US
Mailing Address - Phone:206-598-0502
Mailing Address - Fax:206-598-0516
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-0502
Practice Address - Fax:206-598-0516
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00124922163W00000X, 163W00000X
WAAP30007395363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA25671UOtherREGENCE BLUE SHIELD
WA0216675OtherLABOR & INDUSTRIES PIN
NJ01789066Medicaid
WA9651894Medicaid
WA8863672Medicare PIN
WA25671UOtherREGENCE BLUE SHIELD