Healthcare Provider Details

I. General information

NPI: 1063035624
Provider Name (Legal Business Name): DINA E MCNEIL ARNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2758 78TH AVE SE APT 412
MERCER ISLAND WA
98040-3565
US

IV. Provider business mailing address

7683 SE 27TH ST # 294
MERCER ISLAND WA
98040-2804
US

V. Phone/Fax

Practice location:
  • Phone: 206-867-5005
  • Fax:
Mailing address:
  • Phone: 206-867-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DINA E MCNEIL
Title or Position: PMHNP/OWNER
Credential: DNP, ARNP
Phone: 407-756-6841