MEDICARE: LINDSEY ROYAL HURT PMHNP-BC

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
1	163W00000X	Registered Nurse	RN60517507	WA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61339695	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP61339695	OTHER	WA	STATE LICENSURE

General Provider Information

NPI Number	:	1457581720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ROYAL HURT PMHNP-BC

Provider Business Mailing Address
First Line	:	22620 SE 4TH ST STE 130
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	256-594-5313
Fax Number	:	425-689-1306

Provider Business Practice Location Address
First Line	:	22620 SE 4TH ST STE 130
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	425-659-5313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2009
Last Update Date	:	01/07/2025

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