Provider Demographics
NPI:1669614186
Name:WILLIAMS, JUVANN M (ARNP)
Entity type:Individual
Prefix:
First Name:JUVANN
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JUVANN
Other - Middle Name:M
Other - Last Name:WOLFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14632 NE 174TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6246
Mailing Address - Country:US
Mailing Address - Phone:206-919-1716
Mailing Address - Fax:
Practice Address - Street 1:14632 NE 174TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6246
Practice Address - Country:US
Practice Address - Phone:206-919-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00058942163W00000X
WAAP30001133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse