Healthcare Provider Details

I. General information

NPI: 1609408590
Provider Name (Legal Business Name): LINDSAY SCATTERGOOD-KEEPPER DNP, ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST
SEATTLE WA
98195-7263
US

V. Phone/Fax

Practice location:
  • Phone: 920-639-3903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61063308
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60588816
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: