Provider Demographics
NPI:1528333127
Name:TREMAIN, DIANE (NP-C)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:TREMAIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2619
Mailing Address - Country:US
Mailing Address - Phone:425-789-3789
Mailing Address - Fax:
Practice Address - Street 1:8609 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2619
Practice Address - Country:US
Practice Address - Phone:425-789-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60777583363LF0000X
ARA03676363LF0000X
MO2012004441363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60777583OtherLICENSE
ARATP000452OtherLICENSE
MO2012004441OtherLICENSE