Provider Demographics
NPI:1730663246
Name:RODAS GALINDO, KEVIN DAVID (PMHNP)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DAVID
Last Name:RODAS GALINDO
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9311 SE 36TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3741
Mailing Address - Country:US
Mailing Address - Phone:206-312-5373
Mailing Address - Fax:
Practice Address - Street 1:9311 SE 36TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3741
Practice Address - Country:US
Practice Address - Phone:206-312-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61194159363LP0808X
CA95177998163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health