Healthcare Provider Details

I. General information

NPI: 1114562824
Provider Name (Legal Business Name): STEVEN PLINE DNP, ARNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2019
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 4TH AVE STE 350
SEATTLE WA
98121-2364
US

IV. Provider business mailing address

2101 4TH AVE STE 350
SEATTLE WA
98121-2364
US

V. Phone/Fax

Practice location:
  • Phone: 206-771-1753
  • Fax:
Mailing address:
  • Phone: 206-771-1753
  • Fax: 206-508-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60876181
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61171715
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: