Healthcare Provider Details

I. General information

NPI: 1457581720
Provider Name (Legal Business Name): LINDSEY ROYAL HURT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22620 SE 4TH ST STE 130
SAMMAMISH WA
98074-7375
US

IV. Provider business mailing address

22620 SE 4TH ST STE 130
SAMMAMISH WA
98074-7375
US

V. Phone/Fax

Practice location:
  • Phone: 425-659-5313
  • Fax:
Mailing address:
  • Phone: 256-594-5313
  • Fax: 425-689-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60517507
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61339695
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: