Basic Information
Provider Information
NPI: 1255387551
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERKINS
FirstName: JANE
MiddleName: N.
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1101 MADISON ST
Address2: SUITE 1050
City: SEATTLE
State: WA
PostalCode: 981041306
CountryCode: US
TelephoneNumber: 2065150000
FaxNumber: 2065150001
Practice Location
Address1: 1101 MADISON ST
Address2: SUITE 1050
City: SEATTLE
State: WA
PostalCode: 981041306
CountryCode: US
TelephoneNumber: 2065150000
FaxNumber: 2065150001
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102XAP30006428WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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