Provider Demographics
NPI:1447849724
Name:SAMPSON, DEBORAH VICTORIA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:VICTORIA
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811C ASHWORTH AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8118
Mailing Address - Country:US
Mailing Address - Phone:206-633-5089
Mailing Address - Fax:
Practice Address - Street 1:2100 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6902
Practice Address - Country:US
Practice Address - Phone:206-633-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00064647163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management