Provider Demographics
NPI:1265153142
Name:YORK BANNON, ERIN LILLIAN (RN, ARNP STUDENT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LILLIAN
Last Name:YORK BANNON
Suffix:
Gender:F
Credentials:RN, ARNP STUDENT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LILLIAN
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ARNP STUDENT
Mailing Address - Street 1:18358 DAYTON PL N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4327
Mailing Address - Country:US
Mailing Address - Phone:508-667-0220
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST STE T301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-8736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60486143163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse