Organization
DOMENIQUE EDWARDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOMENIQUE EDWARDS ARNP (OWNER/PROVIDER)
(206) 538-2255
Entity
Organization
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
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336675529
TYPE I NPI
—
Enumeration date
10/18/2021
Last updated
03/22/2023
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