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NPI Code Detail

MEDICARE: DR. MODUPEOLA SONUYI SCOTT DNP, PMHNP-BC

MEDICARE: DR. MODUPEOLA SONUYI SCOTT DNP, 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
1363L00000XNurse PractitionerAP5738AZ
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP61605197WA

General Provider Information

NPI Number : 1871994269
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MODUPEOLA SONUYI SCOTT DNP, PMHNP-BC
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number : 253-681-6626
Fax Number :
Provider Business Practice Location Address
First Line : 9650 15TH AVE SW STE 100
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2576
Country : US
Telephone Number : 206-965-1055
Fax Number : 206-965-1032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2014
Last Update Date : 12/20/2024

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Directions to “ DR. MODUPEOLA SONUYI SCOTT DNP, PMHNP-BC” Practice Location

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