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General NPI Number Information
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NPI Number | 1336672849
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Entity Type | Individual
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Provider Name | LUKE J VANDEKROL ARNP
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Gender | Male
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 21601 76TH AVE W
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City | EDMONDS
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State | WA
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Zip | 98026-7507
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Country | US
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Telephone | 425-640-4981
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Fax | 206-860-6726
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Provider Business Mailing Address
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Address Line | 233 E MAIN ST STE 401
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City | BOZEMAN
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State | MT
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Zip | 59715-5045
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Country | US
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Telephone | 406-219-7835
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Fax | 406-794-0352
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61333792
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60970766
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License Number State | WA
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