Provider Demographics
NPI:1376029157
Name:ESTRADA, ARABELLE (ARNP)
Entity type:Individual
Prefix:
First Name:ARABELLE
Middle Name:
Last Name:ESTRADA
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 1:10024 SE 240TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-5124
Mailing Address - Country:US
Mailing Address - Phone:253-859-2273
Mailing Address - Fax:253-850-8894
Practice Address - Street 1:10024 SE 240TH ST STE 201
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-5124
Practice Address - Country:US
Practice Address - Phone:253-859-2273
Practice Address - Fax:253-850-8894
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60870322363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2105975Medicaid