Provider Demographics
NPI:1841381316
Name:ALBERT, MARILYNN (MSN, APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:MARILYNN
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MSN, APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 E GREEN LAKE WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5489
Mailing Address - Country:US
Mailing Address - Phone:206-524-5656
Mailing Address - Fax:206-524-2841
Practice Address - Street 1:6800 E GREEN LAKE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5489
Practice Address - Country:US
Practice Address - Phone:206-524-5656
Practice Address - Fax:206-524-2841
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001251363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9642497Medicaid
WA9642497Medicaid
WA8885097Medicare PIN