Healthcare Provider Details

I. General information

NPI: 1396819504
Provider Name (Legal Business Name): GWENDOLYN KEISER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 136TH PLACE SE SUITE #110
BELLEVUE WA
98006
US

IV. Provider business mailing address

3633 136TH PLACE SE SUITE #110
BELLEVUE WA
98006
US

V. Phone/Fax

Practice location:
  • Phone: 425-747-7202
  • Fax: 425-643-0635
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP30003727
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN00106801
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: