Provider Demographics
NPI:1801125125
Name:DIXON, GALINA S (NP)
Entity type:Individual
Prefix:
First Name:GALINA
Middle Name:S
Last Name:DIXON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-0415
Mailing Address - Country:US
Mailing Address - Phone:206-399-1434
Mailing Address - Fax:855-750-7844
Practice Address - Street 1:10564 5TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7200
Practice Address - Country:US
Practice Address - Phone:206-339-1434
Practice Address - Fax:360-736-0921
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00263000363LA2200X
WAAP 60268401363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health