Basic Information
Provider Information
NPI: 1649674060
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUMERWELL
FirstName: CATHERINE
MiddleName: V.
NamePrefix:  
NameSuffix:  
Credential: DNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VERRIERE
OtherFirstName: CATHERINE
OtherMiddleName: L.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: DNP
OtherLastNameType: 1
Mailing Information
Address1: 1200 12TH AVE S
Address2: SUITE 901
City: SEATTLE
State: WA
PostalCode: 981442712
CountryCode: US
TelephoneNumber: 2065483114
FaxNumber: 2067626355
Practice Location
Address1: 10521 MERIDIAN AVE N
Address2:  
City: SEATTLE
State: WA
PostalCode: 981339509
CountryCode: US
TelephoneNumber: 2062964990
FaxNumber: 2062050897
Other Information
ProviderEnumerationDate: 10/14/2014
LastUpdateDate: 03/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP60505205WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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