Provider Demographics
NPI:1932315595
Name:POOLE, KARUNA JEAN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KARUNA
Middle Name:JEAN
Last Name:POOLE
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 1:3212 25TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-6515
Mailing Address - Country:US
Mailing Address - Phone:206-722-0878
Mailing Address - Fax:
Practice Address - Street 1:3212 25TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-6515
Practice Address - Country:US
Practice Address - Phone:206-722-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2010-03-12
Deactivation Date:2010-02-23
Deactivation Code:
Reactivation Date:2010-03-12
Provider Licenses
StateLicense IDTaxonomies
WAAP30004862364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult