Provider Demographics
NPI:1689918542
Name:NORTHWEST FAMILY PRACTICE
Entity Type:Organization
Organization Name:NORTHWEST FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KRUMPELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-BC
Authorized Official - Phone:1800-959-2291
Mailing Address - Street 1:3121 E MADISON ST
Mailing Address - Street 2:204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4262
Mailing Address - Country:US
Mailing Address - Phone:180-095-9221
Mailing Address - Fax:800-959-2291
Practice Address - Street 1:3121 E MADISON ST
Practice Address - Street 2:204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4262
Practice Address - Country:US
Practice Address - Phone:180-095-9221
Practice Address - Fax:800-959-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60251144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty