Church, Audrey Jean

Church, Audrey Jean is an sole proprietor health care provider with primary practice located at 2344 Ne Marion Ln , Issaquah WA 98029-3661. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Church, Audrey Jean can be contacted via phone (206) 778-9737.

Contact Information

Primary practice address
2344 Ne Marion Ln Issaquah WA 98029-3661
Phone: (206) 778-9737
Fax: (425) 391-7014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP30004413 Washington

Profile Details

NPI number 1972683571
LBN Legal business name Church, Audrey Jean
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated Apr 24th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972683571 NPPES
Washington MEDICAID 9625377

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