Provider Demographics
NPI:1407684830
Name:ZIEGLER, MATTISEN ROSE SEPT (FNP-C)
Entity type:Individual
Prefix:
First Name:MATTISEN
Middle Name:ROSE SEPT
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MATTISEN
Other - Middle Name:ROSE
Other - Last Name:SEPT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2928
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-2928
Mailing Address - Country:US
Mailing Address - Phone:425-207-5155
Mailing Address - Fax:
Practice Address - Street 1:1389 HUFFMAN PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3519
Practice Address - Country:US
Practice Address - Phone:888-227-3312
Practice Address - Fax:503-893-6847
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK227114363LF0000X, 363LP2300X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care