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General NPI Number Information
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NPI Number | 1093601064
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Entity Type | Organization
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Legal Business Name | HIPPY GANGSTER PLLC
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 19888 40TH AVE W APT 625
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City | LYNNWOOD
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State | WA
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Zip | 98036-6794
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Country | US
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Telephone | 425-377-4301
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Fax |
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Provider Business Mailing Address
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Address Line | 19888 40TH AVE W APT 625
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City | LYNNWOOD
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State | WA
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Zip | 98036-6794
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MONICA NICOLE PREDER
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Credential |
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Telephone | 425-377-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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