Individual
KELSEY MARIE EIDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP61298949
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61298949
WA
Other
Enumeration date
08/05/2021
Last updated
03/29/2023
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