Provider Demographics
NPI:1962495903
Name:LIND, GREGORY ALAN (RN, MSN, ARNP)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ALAN
Last Name:LIND
Suffix:
Gender:M
Credentials:RN, MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 2ND AVE W APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3560
Mailing Address - Country:US
Mailing Address - Phone:425-348-5018
Mailing Address - Fax:
Practice Address - Street 1:3501 SHELBY RD
Practice Address - Street 2:SUITE B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-3599
Practice Address - Country:US
Practice Address - Phone:425-742-9119
Practice Address - Fax:425-787-1055
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001736363LF0000X
WARN00093420163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse