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NPI Code Detail

MEDICARE: DANA B. KLANDERUD ARNP

MEDICARE: DANA B. KLANDERUD 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
1363LF0000XFamily Nurse PractitionerAP60772672WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
28968972OTHERWAMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194246959
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA B. KLANDERUD ARNP
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number : 206-543-6420
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC ST
Second Line :
City : SEATTLE
State : WA
Zip : 98195-0001
Country : US
Telephone Number : 206-598-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2017
Last Update Date : 03/08/2026

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