Individual
MS. DOMENIQUE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5602 CALIFORNIA AVE SW, SEATTLE, WA 98136-1515
(206) 538-2255
(206) 538-2266
Mailing address
2611 SW NEVADA ST UNIT B, SEATTLE, WA 98126-2535
(206) 920-5949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60786069
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60793275
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821751702
TYPE 2 NPI
—
Enumeration date
05/07/2017
Last updated
03/22/2023
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