Individual
MS. AUDREY JEAN CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2344 NE MARION LN, ISSAQUAH, WA 98029-3661
(206) 778-9737
(425) 391-7014
Mailing address
2344 NE MARION LN, ISSAQUAH, WA 98029-3661
(206) 778-9737
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004413
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9625377
—
WA
Enumeration date
10/17/2006
Last updated
04/24/2020
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