Provider Demographics
NPI:1386146686
Name:SEYBOLD, MINDY LYNN (DNP, ARNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:LYNN
Last Name:SEYBOLD
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 1:2101 NE 139TH ST STE 450
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-2325
Mailing Address - Country:US
Mailing Address - Phone:360-487-4848
Mailing Address - Fax:
Practice Address - Street 1:2101 NE 139TH ST STE 450
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2325
Practice Address - Country:US
Practice Address - Phone:360-487-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00172831163W00000X
WAAP61040756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse