Individual
KYLENE RAINE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
21911 120TH ST E, BONNEY LAKE, WA 98391-7838
(509) 750-4992
Mailing address
21911 120TH ST E, BONNEY LAKE, WA 98391-7838
(509) 750-4992
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60126119
WA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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