Provider Demographics
NPI:1700842127
Name:OWENS, DEBORAH SUZANNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUZANNE
Last Name:OWENS
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 1:164 LIMESTONE POINT RD
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-6961
Mailing Address - Country:US
Mailing Address - Phone:360-378-7765
Mailing Address - Fax:
Practice Address - Street 1:1805 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4632
Practice Address - Country:US
Practice Address - Phone:360-848-1744
Practice Address - Fax:360-848-0583
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7952259OtherAETNA
WA75537OtherBLUE SHIELD
WA9627902Medicaid
WA75537OtherBLUE SHIELD
WA29576Medicare ID - Type Unspecified