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General NPI Number Information
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NPI Number | 1023458676
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Entity Type | Individual
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Provider Name | NATHAN P KERESTES DO
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 21800 MARKET PL NW STE 104
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City | POULSBO
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State | WA
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Zip | 98370-6667
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Country | US
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Telephone | 833-411-5469
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Fax | 855-459-3020
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Provider Business Mailing Address
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Address Line | 21800 MARKET PL NW STE 104
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City | POULSBO
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State | WA
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Zip | 98370-6667
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Country | US
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Telephone | 833-411-5469
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Fax | 855-459-3020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP61486367
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DOS-2207
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License Number State | HI
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