Provider Demographics
NPI:1144300989
Name:ADVANCED WOMENS HEALTH
Entity type:Organization
Organization Name:ADVANCED WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-752-8833
Mailing Address - Street 1:2102 NO PEARL
Mailing Address - Street 2:STE 405
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406
Mailing Address - Country:US
Mailing Address - Phone:253-752-8833
Mailing Address - Fax:253-752-5400
Practice Address - Street 1:2102 NO PEARL
Practice Address - Street 2:STE 405
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406
Practice Address - Country:US
Practice Address - Phone:253-752-8833
Practice Address - Fax:253-752-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB29722Medicare PIN