Provider Demographics
NPI:1205942117
Name:WILLIAMS, ESTHER LEE (ARNP)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:LEE
Last Name:WILLIAMS
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 1:233 WILLIAMS
Mailing Address - Street 2:PO BOX 508
Mailing Address - City:MOSSYROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98564-0508
Mailing Address - Country:US
Mailing Address - Phone:360-983-3069
Mailing Address - Fax:360-983-9038
Practice Address - Street 1:108 KINDLE ROAD
Practice Address - Street 2:
Practice Address - City:RANDLE
Practice Address - State:WA
Practice Address - Zip Code:98377
Practice Address - Country:US
Practice Address - Phone:360-497-3333
Practice Address - Fax:360-497-5073
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WARN00099463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0173402OtherL&I ID #
WA3386LEOtherREGENCE RIDER
VA9628868Medicaid
WAP34348Medicare UPIN
WAG8903516Medicare PIN
VA9628868Medicaid