Provider Demographics
NPI:1386958692
Name:JOSE, LOURDES C (ARNP)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:C
Last Name:JOSE
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 LIND AVE SW
Mailing Address - Street 2:STE 170
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4934
Mailing Address - Country:US
Mailing Address - Phone:425-656-5439
Mailing Address - Fax:425-656-5493
Practice Address - Street 1:3600 LIND AVE SW
Practice Address - Street 2:STE 170
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4934
Practice Address - Country:US
Practice Address - Phone:425-656-5439
Practice Address - Fax:425-656-5493
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60146966363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health