Provider Demographics
NPI:1770946113
Name:MATHIAS, LINNEAH (FNP-BC)
Entity type:Individual
Prefix:
First Name:LINNEAH
Middle Name:
Last Name:MATHIAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:LINNEAH
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:145 NEWPORT WAY NW
Mailing Address - Street 2:#D203
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3130
Mailing Address - Country:US
Mailing Address - Phone:636-667-2856
Mailing Address - Fax:
Practice Address - Street 1:15100 SE 38TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1728
Practice Address - Country:US
Practice Address - Phone:425-746-4028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60641098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily