Individual
LUKE J VANDEKROL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(425) 640-4981
(206) 860-6726
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60970766
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61333792
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2148969
—
WA
Enumeration date
04/11/2017
Last updated
12/07/2022
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