Provider Demographics
NPI:1295163483
Name:FLESHMAN, SCOT DARRELL (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SCOT
Middle Name:DARRELL
Last Name:FLESHMAN
Suffix:
Gender:M
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 POINT FOSDICK DR NW STE 306
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1794
Mailing Address - Country:US
Mailing Address - Phone:253-432-4437
Mailing Address - Fax:866-336-4138
Practice Address - Street 1:4423 POINT FOSDICK DR NW STE 306
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1794
Practice Address - Country:US
Practice Address - Phone:253-432-4437
Practice Address - Fax:866-336-4138
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60389712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8939942OtherMEDICARE
WA0342003OtherL&I