Basic Information
Provider Information | |||||||||
NPI: | 1598733883 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | APRIL | ||||||||
FirstName: | EMILY | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | ARNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | GLASSOCK | ||||||||
OtherFirstName: | EMILY | ||||||||
OtherMiddleName: | A | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | ARNP | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 565 EUREKA WAY | ||||||||
Address2: |   | ||||||||
City: | SEQUIM | ||||||||
State: | WA | ||||||||
PostalCode: | 983825074 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3605820808 | ||||||||
FaxNumber: | 3606832712 | ||||||||
Practice Location | |||||||||
Address1: | 840 N 5TH AVENUE, STE 1500 | ||||||||
Address2: |   | ||||||||
City: | SEQUIM | ||||||||
State: | WA | ||||||||
PostalCode: | 98382 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3605822840 | ||||||||
FaxNumber: | 3605822841 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/10/2006 | ||||||||
LastUpdateDate: | 09/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/22/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP30005633 | WA | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | AP30005633 | WA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   |
ID Information
ID | Type | State | Issuer | Description | 7082563 | 05 | WA |   | MEDICAID | 1014159 | 05 | WA |   | MEDICAID |