Provider Demographics
NPI:1558651513
Name:MCNEIL, DINA ELAINE (DNP, ARNP)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:ELAINE
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 78TH AVE SE APT C412
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3565
Mailing Address - Country:US
Mailing Address - Phone:206-867-5005
Mailing Address - Fax:
Practice Address - Street 1:7683 SE 27TH ST # 294
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2804
Practice Address - Country:US
Practice Address - Phone:206-867-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9263135363LF0000X
WAAP60635951363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily