Healthcare Provider Details

I. General information

NPI: 1366049389
Provider Name (Legal Business Name): KERI DAMSGAARD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 NE 77TH AVE STE 308
VANCOUVER WA
98662-6705
US

IV. Provider business mailing address

713 WALTERS MILL RD
FOREST HILL MD
21050-1423
US

V. Phone/Fax

Practice location:
  • Phone: 360-930-6535
  • Fax: 855-644-3001
Mailing address:
  • Phone: 360-930-6535
  • Fax: 855-644-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61255006
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN60658286
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: