Provider Demographics
NPI:1902071624
Name:ARJAL, GENEVIEVE KATHLEEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:KATHLEEN
Last Name:ARJAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:KATHLEEN
Other - Last Name:NEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:125 E LYNN ST
Mailing Address - Street 2:#304
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3290
Mailing Address - Country:US
Mailing Address - Phone:303-489-4112
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MAILSTOP CSB-240
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60022066363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8873697Medicare PIN
WAG8877611Medicare PIN