Individual
PHONEMALY OUTHICHAMPHONE KEOMANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
105 W 21ST AVE, KENNEWICK, WA 99337-4910
(509) 222-6203
(509) 222-6201
Mailing address
105 W 21ST AVE, KENNEWICK, WA 99337-4910
(509) 222-6203
(509) 222-6201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60127551
WA
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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