Provider Demographics
NPI:1881677060
Name:OKEEFFE, EILEEN PATRICIA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:PATRICIA
Last Name:OKEEFFE
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 1:12910 TOTEM LAKE BLVD NE STE 102
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2901
Mailing Address - Country:US
Mailing Address - Phone:425-899-4455
Mailing Address - Fax:425-899-4434
Practice Address - Street 1:12910 TOTEM LAKE BLVD NE STE 102
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2901
Practice Address - Country:US
Practice Address - Phone:425-899-4455
Practice Address - Fax:425-899-4434
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001774363LF0000X, 363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
080124875OtherMEDICARE RAILROAD
WA114285OtherLABOR & INDUSTRIES
WAGAB04254Medicare PIN
WAS55853Medicare UPIN