Provider Demographics
NPI:1902602949
Name:DEBRUIN, KATE J (RN)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:J
Last Name:DEBRUIN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:JENNIFER
Other - Last Name:DEBRUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:632 BAKER ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2911
Mailing Address - Country:US
Mailing Address - Phone:971-985-0717
Mailing Address - Fax:
Practice Address - Street 1:5197 NE LOWER RIVER ROAD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660
Practice Address - Country:US
Practice Address - Phone:360-205-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60937973163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health