Provider Demographics
NPI:1386893253
Name:DEMPSEY, MARJA ANNE (AGACNP-BC, FNP)
Entity type:Individual
Prefix:MS
First Name:MARJA
Middle Name:ANNE
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:AGACNP-BC, FNP
Other - Prefix:MS
Other - First Name:MARJA
Other - Middle Name:ANNE
Other - Last Name:HANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC, FNP
Mailing Address - Street 1:295 LAFAYETTE ST 7TH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:855-613-0778
Mailing Address - Fax:
Practice Address - Street 1:24432 SE 4TH PL
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-3435
Practice Address - Country:US
Practice Address - Phone:253-686-2782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18427363LA2100X
WAAP60081460363LF0000X, 363LA2100X
CANP 18427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAV092ZMedicare PIN