Provider Demographics
NPI:1235307737
Name:LASH, BONNIE A (FNP)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:A
Last Name:LASH
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1344 WINTERGREEN LANE
Mailing Address - Street 2:STE 100
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110
Mailing Address - Country:US
Mailing Address - Phone:206-201-0488
Mailing Address - Fax:206-201-0490
Practice Address - Street 1:1344 WINTERGREEN LANE
Practice Address - Street 2:STE 100
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110
Practice Address - Country:US
Practice Address - Phone:206-201-0488
Practice Address - Fax:206-201-0490
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2024-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK1277363LF0000X
WAAP60462750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00903700Medicaid
WA2082727Medicaid