Individual
GEORGE H. GLADE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1800 WESTLAKE AVE N STE 303, SEATTLE, WA 98109-2782
(206) 938-9580
(206) 938-1173
Mailing address
1800 WESTLAKE AVE N. #303, SEATTLE, WA 98109
(206) 938-9580
(206) 938-1173
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00114137
WA
363L00000X
Nurse Practitioner
AP30004465
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004465
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94133U
REGENCE BLUE SHIELD PIN
WA
05
—
9622705
—
WA
Enumeration date
05/16/2006
Last updated
06/06/2013
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