Provider Demographics
NPI:1861432866
Name:VIRTUE, JERRI L (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JERRI
Middle Name:L
Last Name:VIRTUE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34936
Mailing Address - Street 2:DEPT # 5006
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1936
Mailing Address - Country:US
Mailing Address - Phone:206-439-2988
Mailing Address - Fax:206-431-3939
Practice Address - Street 1:22000 MARINE VIEW DR S
Practice Address - Street 2:SUITE 200
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6233
Practice Address - Country:US
Practice Address - Phone:206-870-7331
Practice Address - Fax:206-878-0951
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30002428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS18292Medicare UPIN