Provider Demographics
NPI:1841372117
Name:SONNEY, JENNIFER TEDDER (ARNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TEDDER
Last Name:SONNEY
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 1:1959 NE PACIFIC ST BOX 357262
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-685-2161
Mailing Address - Fax:
Practice Address - Street 1:4700 PT FOSDICK DR NW
Practice Address - Street 2:#211
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-851-5665
Practice Address - Fax:253-627-0855
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007385363L00000X, 363LP0200X
WARN00150593363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner