Individual provider · Type 1 NPI
Keondra Martinique Rustan, PMHNP-DNP, PhD
Psychiatric/Mental Health Nurse Practitioner · Seattle, WA
NPI number
1699495929
Active
Practice location
1600 S Lane St
Seattle, WA 98144-2810
Mailing address
3116 164th St SW Apt 1406
Lynnwood, WA 98087-3250
Other practice locations
- 3116 164th St SW Apt 1406, Lynnwood, WA 98087-3250 · (760) 895-5514
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | ARNP.AP.70007587-NP (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1699495929
Keondra Martinique Rustan, PMHNP-DNP, PhD's National Provider Identifier is 1699495929, issued on Aug 29, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Seattle, WA. The record was last updated on Aug 18, 2025.