Provider Demographics
NPI:1891470910
Name:MAYZELL, EMILY (MSN, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MAYZELL
Suffix:
Gender:
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 131ST CT NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-5077
Mailing Address - Country:US
Mailing Address - Phone:901-277-7462
Mailing Address - Fax:
Practice Address - Street 1:1412 SW 43RD ST STE 315
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4803
Practice Address - Country:US
Practice Address - Phone:901-277-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61461052163WP0200X
TX938604163WP0200X
TX1127431363L00000X, 363LP0200X
WAAP61508314363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner