PREMIER DIABETES CARE PLLC NPI 1235696568

NPI Information

NPI: 1235696568
Provider Name: PREMIER DIABETES CARE, PLLC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Organization

Specialization: Adult Health

Address:
16404 SMOKEY POINT BLVD
SUITE 102
ARLINGTON, WA
ZIP 98223
Phone: (425) 318-7144
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PREMIER DIABETES CARE, PLLC is an adult health nurse practitioner in Arlington, WA. PREMIER DIABETES CARE, PLLC NPI is 1235696568. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16404 SMOKEY POINT BLVD
SUITE 102
ARLINGTON, WA
ZIP 98223
Phone: (425) 318-7144
Fax: (425) 748-7378

The provider's authorized official is Kay Lee Moua .
The authorized official title is President/owner and has the following contact phone number (425) 344-0929.

The enumeration date for this NPI number is 2/22/2019 and was last updated on 7/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2125115	MEDICAID	WASHINGTON
2	1235696568	OTHER	WASHINGTON	NPI
3	G8995537	OTHER	WASHINGTON	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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