Provider Demographics
NPI:1447284690
Name:VAN VOORHIS, AUDREY C (ARNP)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:C
Last Name:VAN VOORHIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12982 ROE RD NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1204
Mailing Address - Country:US
Mailing Address - Phone:206-842-2278
Mailing Address - Fax:206-842-5206
Practice Address - Street 1:147 MADRONE LN N
Practice Address - Street 2:BAINBRIDGE WOMEN'S HEALTH CARE CLINIC
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1862
Practice Address - Country:US
Practice Address - Phone:206-842-2278
Practice Address - Fax:206-842-5206
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004804174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist