Individual
KELLY JEANE DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3901 S FIFE ST, TACOMA, WA 98409-7309
(253) 301-6400
Mailing address
3901 S FIFE ST, TACOMA, WA 98409-7309
(253) 301-6400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60089101
WA
363L00000X
Nurse Practitioner
AP61462903
WA
363LA2100X
Acute Care Nurse Practitioner
Primary
AP61462903
WA
Other
Enumeration date
09/03/2020
Last updated
12/18/2024
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