Provider Demographics
NPI:1396794129
Name:BERRY, SYLVIA JEAN (ARNP)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:JEAN
Last Name:BERRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:J
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:325 NINTH AVE
Mailing Address - Street 2:BOX 359777
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-731-2899
Mailing Address - Fax:
Practice Address - Street 1:325 NINTH AVE
Practice Address - Street 2:BOX 359777
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-731-2899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00075231163W00000X
WAAP30003563363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9616731Medicaid
WA0162760OtherLABOR & INDUSTRY
WAAB33291Medicare PIN
WA0162760OtherLABOR & INDUSTRY