Provider Demographics
NPI:1053346411
Name:MERRIFIELD, JOEY (ARNP)
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:
Last Name:MERRIFIELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:BOX 359735
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-1049
Mailing Address - Fax:206-744-5109
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359735
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-1049
Practice Address - Fax:206-744-5109
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003180363L00000X, 363LA2200X, 363LW0102X
WARN00089184163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUW2875OtherREGENCE BLUE SHIELD PIN
WA9632357Medicaid
WA0155094OtherL&I PIN
WAUW2875OtherREGENCE BLUE SHIELD PIN
S59632Medicare UPIN