Provider Demographics
NPI:1043819907
Name:KRABBENDAM, MATTHEW SEAN (DNP)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SEAN
Last Name:KRABBENDAM
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:4804 215TH LN SW UNIT 32
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3661
Mailing Address - Country:US
Mailing Address - Phone:360-298-8960
Mailing Address - Fax:
Practice Address - Street 1:7315 212TH ST SW STE 207
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7610
Practice Address - Country:US
Practice Address - Phone:425-775-9474
Practice Address - Fax:425-670-3554
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61101386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily