Basic Information
| Provider Information | |||||||||
| NPI: | 1871218826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROGAN | ||||||||
| FirstName: | ARELY | ||||||||
| MiddleName: | NOHEMI | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6700 NE 182ND ST APT D304 | ||||||||
| Address2: | |||||||||
| City: | KENMORE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980284866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094495023 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7315 212TH ST SW STE 1207 | ||||||||
| Address2: | |||||||||
| City: | EDMONDS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980267610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257759474 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2022 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP61358226 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.