Provider Demographics
NPI:1760583207
Name:LINSCOTT, NANCY L (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:LINSCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:L
Other - Last Name:GEORGITIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1200 112TH AVENUE NE
Mailing Address - Street 2:SUITE C160
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-453-1039
Mailing Address - Fax:425-453-8955
Practice Address - Street 1:1200 112TH AVENUE NE
Practice Address - Street 2:SUITE C160
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-453-1039
Practice Address - Fax:425-453-8955
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043280207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8384224Medicaid
WAH02432Medicare UPIN
76803035Medicare PIN
WAG8801847Medicare PIN