Provider Demographics
NPI:1841695301
Name:COOLEY, AMY CATHERINE (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:COOLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11213 NE 91ST ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5735
Mailing Address - Country:US
Mailing Address - Phone:206-276-0913
Mailing Address - Fax:
Practice Address - Street 1:13505 NE 75TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4032
Practice Address - Country:US
Practice Address - Phone:425-936-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00142419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse