Provider Demographics
NPI:1871682856
Name:O'NEILL, ANN MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:O'NEILL
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 1:12040 NE 128TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-1000
Mailing Address - Fax:
Practice Address - Street 1:12822 124TH LN NE
Practice Address - Street 2:MS-9
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7612
Practice Address - Country:US
Practice Address - Phone:424-899-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007041363L00000X
WA00092289163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q65317Medicare UPIN