Basic Information
Provider Information
NPI: 1619445517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHANDLER
FirstName: BRIDGETT
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34703
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241703
CountryCode: US
TelephoneNumber: 2536816603
FaxNumber: 2067648005
Practice Location
Address1: 10030 SW 210TH ST
Address2:  
City: VASHON
State: WA
PostalCode: 980706584
CountryCode: US
TelephoneNumber: 2064633671
FaxNumber: 2064631090
Other Information
ProviderEnumerationDate: 11/08/2018
LastUpdateDate: 07/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN60864680WAN Nursing Service ProvidersRegistered Nurse 
363LF0000XNP61226766WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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