Healthcare Provider Details

I. General information

NPI: 1942917182
Provider Name (Legal Business Name): LYNDENNE GADIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NW 95TH ST
SEATTLE WA
98117-2027
US

IV. Provider business mailing address

120 NW 95TH ST
SEATTLE WA
98117-2027
US

V. Phone/Fax

Practice location:
  • Phone: 206-289-3085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN00087857
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: