Provider Demographics
NPI:1679647796
Name:LAEMMLE, KAREN (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LAEMMLE
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 1:325 9TH AVE
Mailing Address - Street 2:BOX 359829
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-4602
Mailing Address - Fax:206-744-8623
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359829
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-4602
Practice Address - Fax:206-744-8623
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007384363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0219115OtherL&I PIN
WA43758UOtherREGENCE RIDER NUMBER
WA9652983Medicaid
Q78098Medicare UPIN
WA43758UOtherREGENCE RIDER NUMBER