Provider Demographics
NPI:1023694908
Name:OMER, BEHAUDEN (ARNP)
Entity type:Individual
Prefix:
First Name:BEHAUDEN
Middle Name:
Last Name:OMER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:MR
Other - First Name:BEHAUDEN
Other - Middle Name:
Other - Last Name:OMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BEHAUDEN OMER, RN
Mailing Address - Street 1:3250 AIRPORT WAY S STE 227
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-2167
Mailing Address - Country:US
Mailing Address - Phone:425-477-9208
Mailing Address - Fax:
Practice Address - Street 1:3250 AIRPORT WAY S STE 227
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2167
Practice Address - Country:US
Practice Address - Phone:425-477-9208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00172133163W00000X
WAAP61237807363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse