Church, Audrey Jean
Church, Audrey Jean is an sole proprietor health care provider with primary practice located at 2344 Ne Marion Ln , Issaquah WA 98029-3661. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Church, Audrey Jean can be contacted via phone (206) 778-9737.Contact Information
Primary practice address
2344 Ne Marion Ln
Issaquah WA 98029-3661
Phone: (206) 778-9737
Fax: (425) 391-7014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | AP30004413 | Washington |
Profile Details
| NPI number | 1972683571 |
|---|---|
| LBN Legal business name | Church, Audrey Jean |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Apr 24th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972683571 | NPPES |
| Washington | MEDICAID | 9625377 |
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