Individual
KEANA STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3510 STEELHAMMER LANE, CENTRALIA, WA 98531-4551
(360) 623-8020
(360) 736-3139
Mailing address
3510 STEELHAMMER LANE, CENTRALIA, WA 98531
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
60933744
WA
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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