Provider Demographics
NPI:1588701858
Name:AMES, KATHLEEN A (RN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:AMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3462 HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99181-9727
Mailing Address - Country:US
Mailing Address - Phone:509-937-4712
Mailing Address - Fax:
Practice Address - Street 1:6203 AGENCY LOOP RD.
Practice Address - Street 2:
Practice Address - City:WELLLPINIT
Practice Address - State:WA
Practice Address - Zip Code:99040
Practice Address - Country:US
Practice Address - Phone:509-258-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00043466163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care