Provider Demographics
NPI:1710402565
Name:EVERINGHAM, BENTLEY RICHARD (RNFA)
Entity Type:Individual
Prefix:
First Name:BENTLEY
Middle Name:RICHARD
Last Name:EVERINGHAM
Suffix:
Gender:M
Credentials:RNFA
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 2847
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0130
Mailing Address - Country:US
Mailing Address - Phone:206-427-1366
Mailing Address - Fax:
Practice Address - Street 1:1945 16TH LN NE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-7330
Practice Address - Country:US
Practice Address - Phone:206-427-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00152528163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant