Provider Demographics
NPI:1801291935
Name:BARTHEL, DEANNA L (AGNP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:L
Last Name:BARTHEL
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:L
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGNP
Mailing Address - Street 1:PO BOX 5824
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5800
Mailing Address - Country:US
Mailing Address - Phone:425-424-2100
Mailing Address - Fax:
Practice Address - Street 1:12900 NE 180TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-5773
Practice Address - Country:US
Practice Address - Phone:425-424-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60882899363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCQ843AMedicare PIN