Provider Demographics
NPI:1801577119
Name:DASHTESTANI, LILY ROYA (DNP, ARNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:LILY
Middle Name:ROYA
Last Name:DASHTESTANI
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14925 19TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6010
Mailing Address - Country:US
Mailing Address - Phone:206-641-5488
Mailing Address - Fax:
Practice Address - Street 1:604 OAKESDALE AVE SW STE 102
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5204
Practice Address - Country:US
Practice Address - Phone:206-641-5488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60812154163W00000X
WAAP61465974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse