Provider Demographics
NPI:1013406560
Name:DEES, KELSEE CHRISINE
Entity Type:Individual
Prefix:
First Name:KELSEE
Middle Name:CHRISINE
Last Name:DEES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 N 196TH PL APT P101
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-2772
Mailing Address - Country:US
Mailing Address - Phone:775-741-3102
Mailing Address - Fax:
Practice Address - Street 1:2323 N 196TH PL APT P101
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-2772
Practice Address - Country:US
Practice Address - Phone:775-741-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60633976164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse