Provider Demographics
NPI:1841366036
Name:ROSANSKI, EDWARD MICHAEL (ARNP, RN)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:MICHAEL
Last Name:ROSANSKI
Suffix:
Gender:M
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 COLUMBIA ST NW STE 102
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4447
Mailing Address - Country:US
Mailing Address - Phone:537-527-3202
Mailing Address - Fax:360-252-6466
Practice Address - Street 1:500 COLUMBIA ST NW STE 102
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4447
Practice Address - Country:US
Practice Address - Phone:537-527-3202
Practice Address - Fax:602-526-4663
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00107991163WP0809X
WAAP30004113363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9630724Medicaid
WAP00307329OtherRAILROAD MEDICARE
563251Medicare UPIN
WA9630724Medicaid