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NPI Code Detail

MEDICARE: KEITH W. VAN METER ARNP

MEDICARE: KEITH W. VAN METER ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN00068957WA
2363LA2200XAdult Health Nurse PractitionerAP30003468WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10161862OTHERWALABOR & INDUSTRY
226859UOTHERWAREGENCE BLUESHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073532305
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH W. VAN METER ARNP
Provider Business Mailing Address
First Line : 1959 NE PACIFIC ST # 356158
Second Line :
City : SEATTLE
State : WA
Zip : 98195-6158
Country : US
Telephone Number : 206-598-8412
Fax Number : 206-598-6986
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST # 356158
Second Line :
City : SEATTLE
State : WA
Zip : 98195-6158
Country : US
Telephone Number : 206-548-8412
Fax Number : 206-598-6986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/30/2013

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