Individual
JEANNETTE M PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1101 MADISON ST STE 700, SEATTLE, WA 98104
(206) 215-6300
(206) 215-6301
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
RN00084815
WA
363L00000X
Nurse Practitioner
AP30006506
WA
363LW0102X
Women's Health Nurse Practitioner
AP30006506
WA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
AP30006506
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242647
L&I
WA
05
—
1619081700
—
WA
05
—
9638073
—
WA
Enumeration date
08/18/2006
Last updated
08/27/2018
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