Provider Demographics
NPI:1831723907
Name:ALDINGER, JERENE (ARNP)
Entity type:Individual
Prefix:
First Name:JERENE
Middle Name:
Last Name:ALDINGER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 N CREEK PKWY N STE 202
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8202
Mailing Address - Country:US
Mailing Address - Phone:425-287-5500
Mailing Address - Fax:425-287-6440
Practice Address - Street 1:11812 N CREEK PKWY N STE 202
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8202
Practice Address - Country:US
Practice Address - Phone:425-287-5500
Practice Address - Fax:425-287-6440
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61119213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2175860Medicaid