Healthcare Provider Details

I. General information

NPI: 1326094186
Provider Name (Legal Business Name): LINDA L PELLAND A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 FAUNTLEROY WAY SW
SEATTLE WA
98126-3471
US

IV. Provider business mailing address

4550 FAUNTLEROY WAY SW
SEATTLE WA
98126-3471
US

V. Phone/Fax

Practice location:
  • Phone: 425-888-5511
  • Fax: 360-825-6536
Mailing address:
  • Phone:
  • Fax: 360-825-6536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAP30005870
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30005870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: