MEDICARE: LINDA L PELLAND A.R.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	AP30005870	WA
2	363LF0000X	Family Nurse Practitioner	AP30005870	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326094186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA L PELLAND A.R.N.P.

Provider Business Mailing Address
First Line	:	4550 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3471
Country	:	US
Telephone Number	:
Fax Number	:	360-825-6536

Provider Business Practice Location Address
First Line	:	4550 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3471
Country	:	US
Telephone Number	:	425-888-5511
Fax Number	:	360-825-6536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	12/08/2020

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