Provider Demographics
NPI:1982026985
Name:PETRINA GAVRILIS FNP-BC ARNP FAMILY HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:PETRINA GAVRILIS FNP-BC ARNP FAMILY HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PETRINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GAVRILIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:253-282-7195
Mailing Address - Street 1:6141 KIEL CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-6539
Mailing Address - Country:US
Mailing Address - Phone:253-282-7195
Mailing Address - Fax:
Practice Address - Street 1:6141 KIEL CT SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98513-6539
Practice Address - Country:US
Practice Address - Phone:253-282-7195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAUBI 603-362-414251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health