Individual
MS. NIDIA GAMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
2323 JENSEN ST, ENUMCLAW, WA 98022, ENUMCLAW, WA 98022
(360) 825-2541
Mailing address
3100 SE 168TH AVE APT 28, VANCOUVER, WA 98683-2104
(909) 510-2871
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2022114165
OR
164W00000X
Licensed Practical Nurse
Primary
61064484
WA
164W00000X
Licensed Practical Nurse
695054
CA
164X00000X
Licensed Vocational Nurse
61064484
WA
164X00000X
Licensed Vocational Nurse
62868
ID
314000000X
Skilled Nursing Facility
62868
ID
Other
Enumeration date
04/12/2023
Last updated
11/14/2024
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