Provider Demographics
NPI:1265741193
Name:GUIDRY, DAVID M (ARNP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:GUIDRY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 42ND AVE SW APT 710
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4270
Mailing Address - Country:US
Mailing Address - Phone:225-405-9951
Mailing Address - Fax:
Practice Address - Street 1:4727 42ND AVE SW APT 710
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4270
Practice Address - Country:US
Practice Address - Phone:225-405-9951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60184640363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health