Healthcare Provider Details

I. General information

NPI: 1962495903
Provider Name (Legal Business Name): GREGORY ALAN LIND RN, MSN, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 SHELBY RD SUITE B
LYNNWOOD WA
98087-3599
US

IV. Provider business mailing address

1001 2ND AVE W APT 301
SEATTLE WA
98119-3560
US

V. Phone/Fax

Practice location:
  • Phone: 425-742-9119
  • Fax: 425-787-1055
Mailing address:
  • Phone: 425-348-5018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30001736
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00093420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: