Individual
KENNEDY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8001
Mailing address
170 E RHODODENDRON PL, SHELTON, WA 98584-9676
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN.61608385
WA
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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