Provider Demographics
NPI:1770520231
Name:RICE, DOMENICA (CNM, ARNP)
Entity type:Individual
Prefix:
First Name:DOMENICA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:DOMENICA
Other - Middle Name:
Other - Last Name:DROLLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 SPRUCE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2474
Mailing Address - Country:US
Mailing Address - Phone:206-548-3114
Mailing Address - Fax:
Practice Address - Street 1:415 N 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3701
Practice Address - Country:US
Practice Address - Phone:206-782-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA: AP30005971363LW0102X
WAAP30005971367A00000X
WARN00123713163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8882236Medicare PIN
WAP36663Medicare UPIN
WAG8882237Medicare PIN