Individual
DIANE DERBOGHOSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UW CAMPUS, EAST STEVENS CIRCLE, SEATTLE, WA 98195-4410
(206) 616-2495
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30003781
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237080
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
9615683
—
WA
Enumeration date
10/27/2006
Last updated
07/08/2007
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