Provider Demographics
NPI:1093154858
Name:WILLIAMSON, DEBORAH S (RN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:WILLIAMSON
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 1:22100 108TH AVE E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-8871
Mailing Address - Country:US
Mailing Address - Phone:253-683-6183
Mailing Address - Fax:253-683-6198
Practice Address - Street 1:22100 108TH AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8871
Practice Address - Country:US
Practice Address - Phone:253-683-6183
Practice Address - Fax:253-683-6198
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00149118163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00149118Medicaid