Provider Demographics
NPI:1902091184
Name:JAMES, GERTRUDE A (ARNP)
Entity Type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:A
Last Name:JAMES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-715-4186
Mailing Address - Fax:360-715-4143
Practice Address - Street 1:3015 SQUALICUM PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-715-4186
Practice Address - Fax:360-715-4143
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007840363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0238747OtherL&I AND CRIME VICTIMS
WA3015JAOtherREGENCE
WA9040065OtherAETNA
WA1902091184Medicaid
WA3015JAOtherREGENCE