Provider Demographics
NPI:1548525637
Name:HESTMARK VAN BUECKEN, DANA ELIZABETH (MN, RN)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ELIZABETH
Last Name:HESTMARK VAN BUECKEN
Suffix:
Gender:F
Credentials:MN, RN
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:ELIZABETH
Other - Last Name:HESTMARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6278 NE RADFORD DR
Mailing Address - Street 2:APT. 3114
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8712
Mailing Address - Country:US
Mailing Address - Phone:303-437-3716
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60173957163W00000X
WAAP60317796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse