Provider Demographics
NPI:1386640639
Name:MCKEE, JANE E (MSN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:MCKEE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:E
Other - Last Name:DEERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17917 VASHON HWY SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-5204
Mailing Address - Country:US
Mailing Address - Phone:206-463-2800
Mailing Address - Fax:
Practice Address - Street 1:17917 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5204
Practice Address - Country:US
Practice Address - Phone:206-463-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00126540163W00000X
WAAP30005569363LF0000X
AZAP2345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9637323Medicaid
AZ120888Medicare UPIN
S50365Medicare UPIN
WA9637323Medicaid