Provider Demographics
NPI:1073280277
Name:DEVANEY, KIERSTI (ARNP)
Entity Type:Individual
Prefix:
First Name:KIERSTI
Middle Name:
Last Name:DEVANEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KIERSTI
Other - Middle Name:
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1600 116TH AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3099
Mailing Address - Country:US
Mailing Address - Phone:425-454-5311
Mailing Address - Fax:425-454-8188
Practice Address - Street 1:10004 204TH AVE E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-6539
Practice Address - Country:US
Practice Address - Phone:253-848-5951
Practice Address - Fax:253-845-7073
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61218554363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner