Individual
GWEN MUTHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
800 5TH AVE STE 600, SEATTLE, WA 98104
(888) 227-3312
(206) 215-1429
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60095376
WA
363L00000X
Nurse Practitioner
AP60200007
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60200007
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316236706
—
WA
Enumeration date
04/06/2011
Last updated
10/31/2018
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